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(T^HErnYSTERY OfCJJeDI CIN E FjXP L A 1NED 



PREPARED FOR THE USE OF 

Families, Farmers, Mechanics, Travelers, Everybody, 



BY M. LAFAYETTE BYRN, M. D. 



GRADUATE OF "THE UNIVERSITY OF THE CITY OF NEW YORK," AUTHOR OF "POISONS 

IN OUR FOOD," ETC., ETC. 



Copyright 1889, by M. Lafayette Byrn, M. D. 



NEW YORK: 

THE COAST CITY PUBLISHING COMPANY, 

No. 49 Nassau Street. 

(NINETIETH EDITION.) 



\ 






according to Act of Congress, in the year 1869, by 

M. LAFAYETTE BYRN, M. D., 

In the Clerk's Office of the District Court of the United States for the Southern District flf 

New York. 

Entered, according to Act of Congress, in the year 1876, by 

M. LAFAYETTE BYRN, M. D., 

In the Office of the Librarian of Congress, at Washington, D. C 

Copyright, 1889, By 
M. LAFAYETTE BYRN, M. D. 



PREFACE. 



This book has been written for the " People !" — tb<* rich, 
the poor, tbe old, the young, maie and female, the learned and 
the illiterate, those who are well and those who are sick ; on 
land and on water, in the city and in the country, in the 
rural country-seat of the retired merchant or the log-cabin 
and camp-fire of the hardy pioneer or backwoodsman ; for the 
clerk of sedentary habits, and for the farmer who toils in rain 
and in sunshine ; for the young man far away from home, and 
for the mother who keeps watch over her loved ones through 
the long hours of dreary night in sickness ; — in a word, for 
the million. 

It is intended as a guide for preserving health and prolong- 
ing life, by giving that kino of information (couched in lan- 
guage free from medical technicalities), which has long been 
needed by the masses. It has been my aim not only to sim- 
plify the laws of health and physical education, but to give 
6uch plain descriptions of the various ailments which our 
bodies are subject to, that every one may know from the 
symptoms, each ailment or disease, and be enabled to give thf 
best remedies, where a physician can not be had, or, in cases 
of emergency, to know what to do before the physician 
arrives, so as to alleviate suffering or be the means of 
saving life. 

Also, to enable the reader to treat intelligently and success* 
Tilly max ▼ of the " ills which flesh is heir to,'' which ar« 
aable to occur in a family at any time, without being under 
*be necessity of sending for a physician. 



!▼ Preface. 

All the works that I have previously met with, on this sui> 
jcct, have invariably attempted too much, by giving directiong 
for treatment that the great mass of their readers would be 
unwilling to try. I have endeavored to give simple, brief 
and safe instructions, so no one need be afraid to follow them 
I have, of course, availed myself of all the sources of inform* 
tion possible in the preparation of the work. The study of 
our own natures is, perhaps, the most elevating and ennobling 
subject which can engage the mind, and we ought to deem il 
as much a part of our sacred duty to promote physical health 
and happiness in this life, as to prepare our spirits for the 
fruition of a happy immortality. 

Knowing the weight of responsibility resting upon me in 
issuing a volume like this, for the guidance, comfort, and 
benefit of my fellow-beings, I feel to implore the blessings of 
God, that my labors be not in vain. 

Brooklyn, N. T., 1888. M. LAFAYETTE BYKN", 1C.1A. 



5 

PLATE 1. 



THE FRAME OF THE HUMAN 



The Names by which the different Bones in 
Human Body are Known, 



BODY. 

the 





Pkont View. 

i. The back-bone or spinal column. 

a. The skull or head of the human body. 

3. The under jaw. 

4. The sternum or breast-bone. 

5. The ribs. 

6. The cartilages which connect the ribs with 

the breast-bone. 

7. The clavicle or collar-bone. 

8. The humerus, or bone of the arm. 

9. The shoulder-joint. 

w» Thr rarliiK. ( two bones running parallel with 

I? The ulna ! each 0t - her from the elbow to 
' the wrist. 



Back View. 

13. The wrist. 

14. The bones of the hand. 

15. The pelvis, or haunch-bone. 

16. The sacrum, a wedge-shaped bone at th« 

lower end of the back-bone. 

17. The hip-joint. 

18. The thigh-bone. 

19. The patella or cap of the knee. 

20. The knee-joint. 

21. The fibula, or lesser bone of the leg. 

22. The tibia, or shin-bone of the leg. 

23. The ankle-joint. 

24. The bones of the feet. 



12. The elbow-joint. 

We present here two Views of the Human Frame ; they will be found very useful to our 
readers as a matter of information and satisfaction, as they will be able to tell the exact 
location, formation and peculiarities of the various parts of the Human System ; especially 
In cases of fractures, dislocations, wounds, etc., will it be found of value. 

(See Pages 213 to 286.) 




Tas Heart anb Luwes. 



Th«se are placed within the chest, at the upper end of the 
fetfttk. 

By breathing we draw in air, which purifies the blood, and 
prepares it lor nourishing and sustaining the body, and the 
refuse matter which it separates from the blood is carried out. 

The air enters into the lungs where the oxygen contained 
therein comes in contact with the blood, impure from having 
circulated through the body. The oxygen of the air purifies 
this blood, which immediately after passes again through the 
body to return in like manner. 

The blood is carried into the lungs by small blood vessels, er 
tubes. These small tubes are continually poring impure Wood 
into the lungs from the heart, while others are carrying it back 
again into the heart after it is purified. 

As the blood passes through the body, it gathers up the 
decayed and waste particles or atoms, and in this way it 
becomes impure. It then returns to the lungs to be purified, 
and thus made fit again to go out into the system, to perform 
Its life-preserving work anew. 

How neoessary, then, that we should breathe pure air I 

(See Pages 30, 125, 318.) 




Back-Bone, Bibs, and Collar- Bones. 

The Back-bone or Spinal Column, extends from the skull, 
behind, down the middle of the back, and is composed of 
twenty-four short, round, and perforated bones, called vertebrm 
by physicians. They are held together by the cartilage or 
gristle, which is between each bone, thus allowing the spina, 
eolumn to be flexible. 

There are twenty-four ribs, twelve on each side. They grow 
out of the spine, forming a hoop by meeting and being 
fastened to the breast-bone in front. 

They are the framework of that part of the human trunk 
called the chest, in which are the heart and lungs ; they scire 
as a protection to those vital organs. The collar-bones are 
two long slender bones passing over the ribs in front from the 
highest part of the shoulder-bones to the head of the breast- 
bone. The collar-bones prevent the arms from sliding too 
far forward. 

(See Pages 276, 281, 286.) 




Bones of the Hand and Fingers. 

The wrist has eight bones, all being wedge-shaped, and 

strongly united together by ligaments or gristle. In the hand 

and fingers there are nineteen bones, which are also strongly 

held together by powerful ligaments. It will be useful to 

examine this engraving carefully, so as to be well informed 

on the subject in cases of emergency, such as dislocation*, 

sprains, etc. 

{See pages 249, 25(M 




Bones of the Feet. 

there are twenty-six bones in the foot ; they are of peculia. 
ihape, and are all held together by very strong ligament*, 
forming the arch of the foot, called hollow of the foot on the 
muder side, and the instep on the top. 

{Sa pages 122, 2*3.) 



9 
Whalebone, Corsets, and Tight Lacing, 




Hatubal Form and the Bibs. Fashionable Form and the Rxm. 

A dress, tight over the chest, not only binds the ribs together, and thus pre* 
rents the free play of the lungs, but it crowds all the vital organs upon each 
other, so as to derange their proper action-, and obstruct the circulation in all 
parts of the system. Thousands die annually, the victims of consumption, pro- 
duced by tight lacing. 

Such casing and confining are deadly foes to health and life, as everything ii 
Which prevents perfect freedom of action to the vital organs. The ribs, perhaps, 
may be more easily changed than any of the other bones of the body. Their 
very structure is such that the constant pressure or tightness of clothing, day 
after day, needs to be but slight to bend the ribs downward or inward. 

During childhood, the bones are soft and pliable, and readily accommodate 
dhemselves to any position which is habitual. Tight-fitting dresses on a young 
(ady from the age of fourteen to twenty, are the only appliances needed to maka 
her sadly deformed in chest for the remainder of her life, which cannot be of 
long duration in consequence. 

It is well known that a loose and easy dress contributes much to give the sex 
the fine proportions of body that are observable in the Grecian statues, and 
which serve as models to modern artists, Nature being too much disfigured 
among us to afford such model3 now. The Greek women were ignorant of tbi 
ojae of whalebone stays, by which our women distort their shape, instead of dift 
playing it. This practice is carried to so great an excess, that it must in tim* 
dogenerate the species, if not abandoned. It is only a habit, a fashion, tiha 
females have * got into." Now who will confer a blessing on the human race, b 
Introducing the fashion of "common sense," instead of tight-lacing? Try ^ 
Q ye millions, try it 



10 

PLATE VL 




Bids View of Under Jaw-bone and Teeth. 

Clilidi>m Lave twenty teeth — ten in the upper, and ten in 
the lower jaw ; when a child becomes six or seven years of 
age, the teeth loosen, and, if they do not drop out, they should 
be removed without delay, otherwise they will prevent the 
proper formation and regularity of the new permanent teeth, 
•rhich are growing under them. Letter a, in the engraving, 
ihows the position of the new teeth In the under jaw, pushing 
out the old ones. 

(See pages 69, 24.1, 251.) 




The Different Kinds of Teeth. 



¥♦¥*, Internal part, or the ivory of the teeth, is a more solid 
* ^stance than bone, and this is covered with a smooth, white, 
a ad still harder substance, called enamel, which when once 
decayed or destroyed, is never again restored. This enamel 
gives the teeth strength, as well as hardness, for biting, chewing, 
and grinding the food ; it also prevents injury from these ope 
rations, and from the action of acids on the bone of the teeth ; 
and adds much to their beauty and durability. 

Teething and the proper care of the teeth are matters of 
great importance. (See pages 57, 95.) 



11 

PI ATE ru 



Fig. 1 




Fig, J 




The " Circulation of the Blood" (Fig. 1) was discovered 
oy Dr. Harvey. From the earliest of our being to life's 
latest hour, this life-giving process must go on. Beginning 
in the great centre of the system, the heart, the blood is pro- 
pelled through the arteries to the remotest parts, giving nour- 
ishment and life to the system, and is then returned through 
the veins to the heart, and thence to the lungs, to be purified 
by the oxygen in the air. 

The blood thus makes the rounds of the circulation once ia 
aoo at four minutes. 

The "Brain" (Fig. 2) is the centre of the nervous system, 
and weighs from three to four pounds. Every nerve of the 
body is connected with the brain, and may be called the 
"Sentinels of the System," being the mediums of all ova 
•ensations, such as hunger, thirst, pain, etc 

(See pages 134, 194, 329, 332.) 



<% 



12 

PLATE Till. 
Pig. 1. Pig. 1. 





" The Tongue," and Sense of Taste, is represented in Fig. 1. 
The sense of taste lies chiefly on the upper surface of the 
tongue. Branches of the nerve of taste, are also spread over 
the palate or roof of the mouth, and on the inside of the 
cheeks and lips. The tongue, also, assists in various other 
little operations besides taste and talking ; by it we move the 
food in the mouth from side to side, or hold it in a proper 
position for chewing. In sickness the tongue becomes dry 
and hard, as there is no saliva or spittle secreted to moisten it, 
and at such times there is very little taste, as the tongue is 
covered with a fur, or coat. In such cases, the tongue should 
be frequently moistened. (See pages 45, 203, 208.) 

" The Nose," or Sense of Smell, is seen in Fig. 2. The 
sense of smell is situated in the lining of the nostrils. The 
inner surface of the nostrils are lined with a thin mucous 
membrane, over which the branches of the nerve of smell are 
spread, and which are kept constantly moist in their natural 
state with a thin fluid called mucus, which keeps the branches 
of the nerve of smeil in perfect order, and protects them from 
harm. It also catches the odorous or noxious particles which 
are drawn into the nostrils with the air, and are thereby pre* 
vented from being carried deeper into the lungs, where they 
would be injurious. By the act of sneezing these particles 
are ejected from the nostrils. 

(See pages 97, 402, 121 and 231.) 



13 

PLATE IS. 





aUMAN STOMACU AND BOWELS. 



The Human Stomach. 



We here give a fine representation of the Stomach and 
iSowels, united together, (A) in which " 1 " is the stomach, 
r< 2" is the upper portion of the small bowels, "3" the middle 
portion of the small bowels, around which, in the sh^pe of an 
arch, is seen the large bowels ; " 4 " is the rectum v or lower 
outlet of the bowels. 

The food while in the stomach becomes dissolved or digested. 
It is then called chyme ; this passes out of the stomach into 
what is termed the "duodenum" (or upper pa;t of small 
bowels), where it is then separated into two clashes, a milky 
fluid called chyle, or the part which enters into aiid forms the 
life of the blood, and the waste or useless part, which should 
be ejected from the bowels regularly each morning soon after 
rising. " The Stomach," detached from the bo^ els, is seen at 
"B;" at figure "1" is a section of the Esoj hagus, or tuba 
Leading from the throat to the stomach ; ana figure " 2 " is 
the outlet into the upper portion of the bowels. 
{See Pages 104, 158, 41, 52, 218, 320, 341, 0*, 105, 157, 180, 
349 352, 134, 340.) 



14 



A Curved, Bound* Shouldered and Erect Spine. 




How very distressing, and yet how common it is to see curved or deformed 
spines. The habits of children, especially of girls, if not corrected in time, create 
a fearful frequency of this spinal defect. Nature has given to all, both male and 
female, a sufficiency of bone and muscle to sustain them in the most graceful and 
healthy position, and when these are correctly and faithfully used, and their 
strength developed, they fulfil their intended purposes, and keep the form erect. 
Look at the following illustrations of improper positions of the body, and you 
will be able to tell the cause of these deformed spines. 




sxnxAv \ 

Fig. 1. Fig. 2. Fig. 

Old Style and New Style of Desks and Seats for Schools. 

Too many schools are furnished with seats of the same uniform height. If 
they are high enough for the larger scholars, they are too high for the smaller 
children. (See fig. 1.) In sitting, a child should find a support for the back, and 
rest for the entire thigh-bones and feet, otherwise the bones of these, being soft 
and growing, are liable to become distorted, or out of shape. Fig. 2 represents a 
proper position, and fig. 3 an improper position, for sitting. 




Proper and Improper Positions to lie in Bed. 

Curvatures of the spine may be caused by too many pillows upon which the 
head rests while in bed, as represented above. Young persons should lie as 
nearly level as possible, with the head but slightly raised if at all. As they ad- 
vance in life, a more elevated position of the head may be desirable. Most people 
lie upon the right side; some lie upon the back, but this latter position is not 
favorable to those who are liable to nightmare. A frequent change of position is 
very desirable. If you awake during the night, change your position. 



15 




VERTICAL SECTION OF THE ANKLE JOINT AND FOOT OF THE EIGHT SIDE, 

•bowing theformation of joints, the synovial capsules, and ligaments. The reference* 
are not given as difficult and needless to remember, 



Fig. 2. 




THE URINARY BLADDBR, 
•HO WING ITS MUSCULAR FD3RJW. 

8, Left Ureter ; 9, Left portion 
of Seminal Vesicles ; 11, 11, Late. 
ral Lobes of the Prostate Gland, 
14, Urethra, tied with a cord. 



Fig. 3. 




SECTION OF A KIDNEY. 



16 



Fig. 1. 



PLATE XTI. 




LONGITUDINAL SECTION OF THE GLOBE 
OF THE EYE. 

1 marks the course of the outer tunic, called 
the sclerotic, which invests four-fifths of the 
globe, and gives it its peculiar form. It is a 
dense fibrous membrane, thicker behind than 
in front, where it presents a bevelled edge, 
into which fits like a watch-glass the cornea (2) 
which invests the projecting portion of the 
globe, and is composed of four layers, viz., the 
conjunctiva, or cornea propria, consisting of 
thin lamellae, or scaies. connected by an ex- 
tremely fine areolar tissue ; the cornea elashca 
— an elastic and excessively transparent mem- 
brane, which lines the inner surface of the 
last ; and the lining membrane of this front 
vestibule of the Eyeball, whose second tunic 
is formed by the choroid (3) represented by 
the dark line; ciliary ligiment (1), which de- 
velops from its inner sui fare the ciliary pro- 
cesses, and the iris (6), of which the opening 
at 7 represents the pupil. We shall go more 
into details presently as to the nature of these 
several constituents of the tunics and other 
parts of the eye ; at present we will keep to 
general outlines, as represented in the dia- 
gram. The third tunic, then, is the retina (8), 
which is carried forward to the lens (12), by 

the zonula ciliaris, a prolongation of its vascular layers passing along the front of the Canal 
qf Petit i9), which entirely surrounds the lens. In the space marked 10. is contained the 
aqueous humor ; 11 is the posterior chamber ; 12 the lens, more convex behind than before, 
and enclosed in its proper capsule ; 13 marks the inner area of the globe, filled with a thin 
membrane called the hyaloid, and containing the vitreous humor ; 14 is the tubular sheath 
of the membrane, through which passes an artery connected with the capsule of the lens, 
and, at the back of the eye, with the optic nerve, as represented at 16. Of this nerve, If 
marks the neurileuma, or sheath. 



THE EYEBALL DIVESTED OF ITS FIRST TUNIC. 

1, Part of the outer tunic, the sclerotic; 
2, the optic nerve, communicating with the 
ball at the back ; 3, 3, distinguish the out- 
line of the choroid coat; 4, tbe ciliary lig- 
ament, a dense white structure which 
surrounds, like a br^ad ling, the circum- 
ference of the iris (5). This ligament 
serves as a bond of union between the ex- 
ternal aud middle tunics of the Eyeball, 
and serves to conne t the cornea and scler- 
ota at their lines of junction with the iris 
and external layer of the choroid; 6, 6, 
mark the vence vorticosce ; and 7, 7, the 
trunks of these veins at the points where 
they have pierced the sclerotica ; 8, 8, the 
posterior ciliary veins which enter the 
Eyeball in company with the posterior cil- 
iary arteries, by piercing the sclerotica at 
9. The course of one of the long ciliary 
nerves, accompanied by a vein, is marked 
by 10. 



17 




PLATE Xm. 



Fig ft. 




TBANSVEKSE SECTION OF THE 
GLOBE OF THE EYE. 

1, The divided edges of the three tis- 
sues, the sclerotic (outer), choroid (mid- 
dle and dark), and re£in« (inner), which 
last is composed of three merabrareoas 
layers, the external being serous, the 
middle nervous, and the internal vas- 
cular ; 2, the pupil, that central spot, 
which enlarges or contracts, according 
as more or less light is required to be 
admitted ; 3, the iris, so called from 
iris, a rainbow, on account of its variety 
of color in different individuals. It is 

composed of an anterior muscular layer, consisting of radiating fibres, which, 
converging from ihe centre toward the circumference, have the power of dilating 
the pupil ; and als'2> of circular fibres, which, surrorvnding the pupil like a sphincter 
performs the duty of contracting its area. The posterior, or hinder layer, is of a 
deep purple tint, said is hence named uvea, from its Resemblance to a ripe grape. 
This is the surface of the iris presented to view in the above section. 4, ciliary 
processes j 5, scalloped anterior border of the retina. 



POSTEKIOE SEGMENT OF A 
TEAT^SVEKSE SECTION OF THE EYE. 

1, The three outer tunics ; 2, the 
entrance of the optic nerve, with fhe 
vein known as the anteria centralis 
retince piercing its centre ; 4 is the 
foramen of Soemmering, situated in the 
middle of the axis of the eye. This is 
a circular spot, surrounded by a yellow 
halo, call ^d the lirnbus luieus . This halo 
is commonly obscured by a fold of the 
retina (5 N 



18 



PLATE XTV. 



FN. 1. 



Fro. t. 





EYE- APPENDAGES. 



MEIBOMIAN GLANDS. 



1 2, The inner sides of the eyelids; 
3 3, the Conjunctiva; 4, the apertures of 
the glands, along each corner of the 
lids ; 5 5, 6 6, the Papillce lachrymales 
and the Puncta lachrymalia ; 7, the ap- 
ertures of the ducts of the Lachrymal 
gland. 



1, The superior or upper tarsal carti- 
lage, along the lower border of which 
(2) are seen the openings of the Meibo- 
mian glands; 3, the inferior, or lower, 
tarsal cartilage, along the upper edges 
of which are also openings of the above- 
named glands ; 4, the superior or orbi- 
tal portion of the Lachrymal gland, from 
■which come tears ; 5, its inferior or 

palpebral portion ; 6, the Lachrymal ducts, or channels through which the tears 
pass to the outer surface of the eye ; 7, the Plica semilunaris, containing a small 
piate of cartilage, which appears to be the rudiment of a third lid, such as is 
developed in some animals ; 8, the Caruncula lachrymalis, the source of the whitish 
eecretion which so constantly collects in the corner of the eye ; it is covered with 
minute hairs, which can sometimes be seen without the aid of a microscope ; 
9, the Puncta lachrymalis, the point, or external commencement of the ducts, which 
terminate at the lachrymal sac, the position of which is marked by 12 ; as are the 
superior and inferior lachrymal canals by 10 and 11 . The nasal duct, marked b/ 15* 
And 14 is its dilation with the lower meatus of the nose. 



19 




MUSCLES OF THE EYB. 

1, Sphenoid Bone ; % the Optic Nerve ; 3, the Globe of the Eye ; 4, the Upper Musck> 
•ailed the Levator Pa&brce, the Lifter of the Eyelids,- 5, the Superior Oblique, so called 
from the direction in which it draws the Eyeball ; we see its cartilaginous pulley (6), 
and the reflected portion passing downward to its point of connection with the ball, 
beyond which the inferior Oblique has its bony origin — the point of which is marked by 
the little square knob. The other four muscles are called Recti, straight ; the Superior 
Rectus, sometimes called the Levator Oculi, erector of the eyes, and sometimes Superbus, 
because its action gives an expression of pride ; its opposite, 13. the Inferior Rectus, 
sometimes called Deprimus Oculi, depressor of the eye, and Humulis, as giving an 
expression of humility; 10, the Rectus Internum, sometimes called Adductor Oculi, from 
its drawing the Eyeball toward the nose, and Bibitorious, a sort of punning name, in 
allusion to the cup, or orbit, towards which it directs the glance; 11 and 12, Rectus Ex- 
ternum, the one showing its two heads of origin, and the other itj>J;ermination ; the inter- 
vening portion of muscle [having been removed} has the nsSne of Abductor Oculi, 
because it turns the ball outward.; Indiqnabundus is another name for it, as giving an 
expression of scorn. In our diagram, the internal rectus passes behind the optic nerve, 
which partly conceals it; 14, the tunica a'bigania, or white tunic, formed by the 
•xpa&sien of the tendons of the four Recti muscles* 

Fig. 2, 



W 




SEPTUM OP THE NOSE AND ITS NERVES. 

1, Nerve of the lobe of the nose ; 2, olfactory lobe ; 3, serves of the septam ; 4, nerre 
of the palate. 



, 



20 




B1CTION OP MAMMARY GLAND OR FEMALB flRBAST, 

1, 1, Galactophorous Ducts ? 2, 2, "Lobuli. 



Fig. 2. 



Fig. 3, 




*BIGIN OF THE MILK DUCT* 




ULTIMATE FOLLICLES OF THB 
MAMMARY GLANDS. 

a, a, the Secreting Cells ; b. b 
tke Nuclei. 



21 

PLATE XVIL 



£»». 1. 



Fig. 3. 




DIAGRAM OF THE STRUCTURE OF THE 
SKIN. 

a, Epidermis; b b. Pores ; c e. Lay- 
ers of epidermis and rete mucosum ; 
/, Inhalent vessels; g g, Papillae of 
the skin ; h h, Corium or true skin ; 
d, d d. Bulbs of sudoriferous glands 
^'ieninc m the glands b & 

Fig. 3. 




A SWEAT GLAND. 

A vertical section of the sole of th« 
foot — a, the Cuticle or Scarf Skin, th« 
deeper layers of which, dark in cc lor, 
being called the rete mucosum; b. the* 
Papillce ; c, the Cutis or True Skin ; 
and d is the Sweat Gland in a cavity of 
oily globules. 




VERTICAL SECTION OF THE SKIN LARGELY PORES AND PAPILLA OF THE SKIN. 

magnified. On the left is a Magnified View of the Ridges of the 

h Sweat Gland ; i, a Hair enclosed in Cuticle, as seen in the Palm of the Hand wvth the 

its Follicles, and showing its pair of Openings of the Pores in their Furrows. On the rigkfc, 

8ebaceous Glands ; p } a Sebaceous the Cuticle has been removed, leaving corresponding 

Gkaxi. rows of Papillae. 




Description of Plate 18 —I. Frontal branch of the fifth nerve of the brain which 
bestows sensation alone. II. Supei ior maxillary, or that branch of the fifth nerve 
■which supplies the upper jaw, and which, like the last, arising from the sensitive root, 
bestows sensation alone, in. Mental or inferior maxillary branch of the fifth nerve. 
This also comes frcm the sensitive root. It is called mental, liecanse it ia involved in 
that expression which indicates the emotions of the mind. IV. Temporal branches of 
the same fifth nerve. They are distributed on the temples, and are for sensation. V. 
The only branch of the fifth nerve which arises from the smaller or motor root, and 
assists in the motion of those muscles whicn are employed in masticating or chewing. 
VI, VII, VIII, IX. These are spinal nerves — the first of the series which come out 
between the vertebra, in the whole length of the spine, to supply the body generally 
with motion and sensation. A. The facial nerve. It is situated in the front of the ear, 
and is the motor nerve of the features. It sends branches (a) to the muscles cf the 
forehead and eyebrows. Branches (b) to the eyelids. Branches (c) to the muscles 
which move the nostrils and upper lip. Branches (d) to the lower lip. Branches 
ie) going down to the side of the neck. Connections (/) with the spinal nerves of the 
neck. A nerve (g) to a portion of the muscle that is in the back of the head, and to 
muscles of the ear B. The nervus vagus, or the wandering nerve, so named from its 
extensive distribution. This is the grand respiratory nerve C The spinal accessory 
nerve. D. The ninth nerve, which is the motor nerve of the tongue. E. The nerve 
which supplies the diaphragm. F. Branch of the sympathetic nerve. G. A branch of 
the nervus vagus which goes to the superior portion of the larynx or windpipe. H. Aa- 
•ther branch of the vagus which goes to the inferior portion of the larynx. I. The nerv» 
which goes to the tongue and upper part of the gullet, called the pharynx. 



23 



PLATE XIX. 



Fig. 2. 



Fig. 1. 




MESENTERIC CIRCULATION BETWEEN THE BOWELS AND 
NUTRIMENT GLANDS. 



LONGITUDINAL SECTION OP A POR- 
TION OF THE SMALL INTESTINE, 



Fig. 3. 




rAROTTO GLAND OF A SHEEP (UNDER THE CHEf), EXHIBITING T IE BRANCHED AND LOBULATBD 
CHARACTER OF THE GLANDS OF THE HUMAN SIOMACH, AND OTHER PARTS. 



24 
MUusfralions of Healthy and Unhealthy Positions of the Body 




Coeeect Position. Incoeeect Position. 

See how that round-shouldered youth is sitting with his shoulders against tin 
back of the chair, and the lower portion of his spine several inches from it, 
giving his body the shape of a half-hoop. Parents should regard such a position 
in their children with apprehension as to the result, and should rectify it at once. 
The other young gent, has learned a thing or two worth knowing, as you will 
see by his manly, dignified position in his chair. He may be President yet — 
who knows? 




Healthy Position. Unhealthy Position. 

i n upright position, in either sitting or walking, favors a healthy action of all 
the various organs of the system, and besides it gives a graceful and dignified 
appearance to the human form. Children and adults are more or less inclined 
to lean forward with their heads upon their elbows, even when their seats are 
provided with backs ; such a position oft-repeated must in time result unfavor- 
ably. There is a very " don't care" kind of look about one of these young ladiaa; 
if iht lives long enough, she will eare. 




Impkopee Position. Peopee Position. 

Learn to sit up, young man, and to imitate your opposite neighbor ; for tbf 
onnatural position which you have assumed will never make you a good writer 
A bold upright position, with the pen held loosely between the fingers, and 
determined purpose to imitate some definite copy as nearly as possible, is thi 
only true road to success in the art of writing or good penmanship. This young- 
iter on the left looks as if he was " bowing his back for a heavy burthen r ' — and 
ec he is ; if he don't quit it, he will have burthen enough. 



25 



Cultivation and Carelessness. 



A form repre- 
senting a full- 
chested woman. — 
Such a person 
would naturally 
have a strong con- 
stitution,and could 
endure a great 
amount of labor, 
either mentally or 
physically. The 
European ladies 
are more generally 
of the above form 
than the Ameri- 
can, because they 
take more interest 
in cultivating a 
full chest and fine 
form. In future let it be truthfully 
laid that the American ladies not 
wily have " pretty faces " but healthy 
forma, 




FORMS THAT CAN BE 
CULTIVATED. 



This is a fac-eimHa 
in form of a great 
many women that are 
daily met with. Such 
persons are usually 
troubled with that 
sinking sensation, or 
u goneness " at the 
pit of the stomach, 
which is always pro- 
duced by the pressure 
upon it in stooping, 
and might be prevent- 
ed by care in keeping 
back the shoulders, 
expanding the chest, 
and taking that kind 
of exercise so much 
needed, but so muoh 
neglected, called " House- work !" 




FORMS CONTRACT 
ED BY CARELESS- 
NESS OR HABIT. 



"We here see re- 
presented a full- 
chested and erect 
man, one so rarely 
seen, although it is 
no more than can 
be obtained in near- 
ly every person by 
cultivation. A per- 
son with such a 
chest would usually 
be free from disease 
of the Lungs or the 
Heart, and would 
have all the indica- 
tions of being a ro- 
fcttst and long-lived person. It is as 
tuey to have this form as an improper 
Ma, by a little timely training. 





This represents a 
man of stooping form, 
with small Lungs and 
Chest. Such a per- 
son would be almost 
sure to have some 
disease of the Lungs 
Heart, or Stomach, 
and would naturally 
be Consumptive and 
short-lived, because 
the vital powers are 
small. Care should 
be taken to avoid con- 
tracting such a form. 

It is simply the eault of carelessness 

and hab& 



26 




The Female Pelvis. 

We h&Te here a front view of the Pelvis. 1. 1. The os$a m 

nominata, or hip bones. 2. The sacrum, perforated with 
two rows of holes, for the transmission of nerves. 3. The 
tymphysis pubis, or os pubis. 4. The coccyx. 5. 5. Articula- 
tions for the thfgh bones. The antero-posterior diameter of the 
brim, from symphysis pubis to middle of sacrum, measures fom 
Inches and a half. The transverse, from the middle of tb« briar 
on one side, to the same point on the opposite, five inches a«id . 
quarter The obligue diameter measures about five inches. The 
wntero-poster'ior and transverse diameters of the outlet measure, 
each, four inches. The cavity of the pelvis measures, in depth, 
< e inch and » half in front, and four inches and a half poa 



27 



THE WOMB. 

This most important organ in woman is situated in the 
cavity of the pelvis — from whence, when distended, in preg- 
nancy, it rises into the abdomen, with the general lining 
membrane of which and the pelvis, called the peritoneum, it 
is covered. It is of a flattened pear-shape, and it is held in 
its place by elastic ligaments. In its unimpregnated state it 
is about three inches in length by two in breadth across the 
broadest part, and one in thickness. At the period of puberty 
it weighs about one and a half ounces ; after parturition, from 
two to three ounces ; and in the ninth month of utero-gestation, 
from two to four pounds. It is supplied with glands, vessels 




THE WOMB AND ITS APPENDAGES. 

a, Right Ovary ; b, b, the Fimbriae ; c, e, the Fallo- 
pian Tubes ; d, an Ovum being grasped by the 
Fimbriae ; e. an Ovum descending the Fallopian 
Tube to the Womb ; /, Cavity of the Womb ; 
g, g, Walls of the Womb ; h. WaU of the Vagina ; 
*, k, Ligaments of the Organs. 

and nerves, the latter of which constitute an extensive net* 
work over its entire surface. 

The ovaries are two in number — one on each side of the 
uterus, in the groin. They are nearly as large as the male 
testicles, and perform a corresponding function. When the 
germ (or ovum) has been perfected in the ovary, it is cast 
out, and seized by the extremity of one of the fallopian tubes, 
through which it is conducted to the uterus. 



28 
Mode of Applying Bandages, 




(See next page. ) 



29 





Fpaotueb of the Asm. 



Fkactuee of ^he Knee-pan. 





Fbaoture of the Leg. Fbaoturb of the Tmos 



30 



DOUBLE INHALER FOR THE CURE OF CATARRH IN THE HEAD, 




Many years ago I became convinced that the ordinary treatment 
for Catarrh in the Head, prescribed by some of the very best men 
in the medical faculty, was of but little, if any practical utility. I 
therefore made it a matter of study, and made various experiments 
and soon satisfied myself that " Medicated Inhalation" was the 
only rational and successful remedy. To apply this properly I 
invented the Double Inhaler which is represented by the above 
engraving. 



31 

MEDICAL EDUCATION. 

As there are so many imposters in large cities — men pretending to be 
physicians and surgeons, and have never been properly qualified to act in 
such capacity, I have concluded to produce the evidence for the information 
and benefit of those who do not know me personally, of my Medical 
Education having been regularly completed in one of the first Medical 
Schools in America. The following is a copy of the Diploma in Latin, (and 
also a translation in English,) awarded to M. L. Bybn by the University of 
the City of New York, March 3d, 1851 : 

Cancellarius, Professores et Concilium Universitatis XJrbis Neo Eboraci : — 
Omnibus et singulis nasce literas lecturis. 

Salutem in Domino nostro Jesu Christi sempiternam Notum sit, quod no- 
bis placet autoritate publico diplomate huic institutioni collata 

M. L. BYRN, 
Pirum probum eximia Artis Medicse et Chirurgicee Sciencia imbutum exami- 
natione imprimis, habita titulo graduque MEDICINiE DOCTOEIS adornare 
eique omnia Jura Honores Privilegia ad ilium gradem pertinentia concedere. 

In cujis rei Testamonium, his Uteris universitatis hujusce sigillum et 
chirographa nostra appossiumus. Datum er Universitatis sedibus Neo. 
Eboraci a. d. v. Non. Martias, Anno Domini mdcccli et civitatum Beipu- 
blicse Foederataruin septuagesimo quinto. 

JOHN W. DBAPEB, Cancellarius. 
[ JNO. C. GEEEN. Prases. 
ConcUlium, 1 WILLIAM B. MACLAY, Secretarius. 
( A. C. KINGSLAND, Urbis Praetor. 

fGBANVILLE S. PATTISON, M. D , Anat. Prof. 

MABTIN PAINE, M. D.. Mat. Med.et Thorep. Prof. 
Professores, J JOHN W. DBAPEB, M. D., Chemico et Physiol. Prof. 

E. BABTLETT, M. D., Inst, et Prax. Med. Prof. 

G. S. BEDFOBD. M. D., Obstet. Prof. 

S. D. GOSS. M. D., Chirurg. Prof. 
' 'The Chancellor, Professors and Council of the University of the City of 
New York — To all and singular, the persons reading these writings, wishing 
continued health in our Lord Jesus Christ. — Be it Known, that it has pleased 
us under the authority bestowed by public charter in this institution, to adorn 
M. L. Bten, an upright man, in the first place having undergone an exami- 
nation, imbued with the excellent art of medicine and science of surgery, 
with the title and degree Doctor of Medicine, and to grant him all rights, 
honors and privileges pertaining to the said degree. In Testimony, thereof, 
we affix to these letters of this University, the seal and our handwriting. 
Given from the buildings of the University of New York, the 3d day of March, 
1851, and of the Independence of the United States, the 75th." 

(SIGNED.) 

JOHN W. DBAPEB, Chancellor, 
GBANVILLE S. PATTISON, M. D., Professor of Anatomy. 
®?B83^ MABTIN PAINE, M. D., Professor of Materia Medicse and The- 
ijj l. s. Si rapeutics. 

1 - !g JOHN W. DBAPEB, M. D., Prof of Chemistry and Physiology. 
&^v^ m E..BABTLETT, M. D., Professor of the Institutes and Practice 
of Medicine. 
G. S. BEDFOBD, M. D., Professsor of Obstetrics. 
S. D. GOSS, M. D., Professor Surgery. 

(JOHN C. GBEEN, President. 
Council, \ WILLIAM B. MACLAY, Secretary. 
( A. C. KINGSLAND, Mayor, 




Polypodiwm Vulgare, or Common Polypody* 

(the root and tops.) 



This is found in mountains, on rocks, throughout the United States and 
Canada ; the root has a sweet, mucilaginous taste. This plant is good 
for colds, coughs, influenza, and worms. Some of the plant stewed in 
syrup and a tablespoonful given every hour or two, is an excellent, thing in 
colds or chronic cough. United with an equal quantity of liverwort, and 
made into a syrup, it makes an excellent remedy in diseases of the lung 
aod throat ; to be taken freely every two hours. The root powdered, 
and mixed with powdered rhubarb, in equal parts, and the same quantity 
of syrup, given once or twice a day ; from ten to twenty grains at a 
dose, to children, will expel worms after many other remedies fail. It 
may be used also as a tea, in colds, etc. 



33 




Inula Helenium, or Elecampane. 

(the root.) 

This plant is possessed of pretty energetic tonic properties. It 
acts likewise as an excitant, owing to the camphorated oil which it 
contains. It is an excellent article, in combination with others in 
colds and coughs, in pulmonary irritation, (as in consumption, etc.), 
and in some forms of indigestion, when it proceeds from a debility of 
the digestive organs. It may be given in powder, decoction or infusion. 
Dose of the powder, from half to one drachm; decoction or infusion 
(tea), from half an ounce to one ounce, every three or four hours. 



34 




Hedeoma Pulegioides, or American Penwyreyiil- 

(THE TOPS.) 

This is found in all parts of the United States and Canada, im 
dry woods, plains, etc. The fresh or dried plant chewed and the 
mice swallowed, is good to expel wind from the stomach ; made 
into a tea, and taken warm, it produces perspiration very freely. 
In case of suppressed menstruation from cold or fright, a tea 
made of this plant, given warm at bed time, often assists nature 
to restore it ; taken as a tea, mixed with a little spirits, it is 
good to cure pains and cramps caused by drinking cold water, 
suppressed perspiration, etc. The tea should be taken strong; 
warm, and freely. 




Sanguinaria Canadensis, or Blood Boo4* 

(THE ROOT.) 

This is an emetic (producing vomiting), narcotic (iedcxcing 
the pulse and quieting the nerves), expectorant (for cough), etc 
It must be used with care, to avoid taking an over dose. It ii 
recommended in rheumatism, diseases of the liver, typhoid— 
pneumonia, coughs, colds, etc. Dose, from one to five grains 
of the root powdered, and given in the form of a pill, every 
three or four hours, according to the symptoms, disease, etc. 



36 




Bupatorium Perfoliatum, or Boneset. 



(*BB LEATK8 AMD PL0WBB8.) 



This is & plant found in most parts of the United States. The 
jrhole plant is exceedingly bitter ; taken as a tea, warm, it pro 
duces vomiting ; taken cold, it acts as a gentle purgative. A 
wine glass or about a gill of the tea taken cold, half an hour 
before each meal, acts as an excellent tonic, and will act almost 
like a charm on some persons who can not take quinine or 
other tonics. The leaves may be powdered also, and given m 
mucilage ; ten or fifteen grains three times a day, as a toaw 
tnd alterative. 




Herberts Vulgaris, or Barberry, 

(THE bush.) 

This shrub blossoms in April and May ; tbe berries ripen In 
June. The whole shrub, even the root, is acid or sour ; the 
bark is yellow and bitter. The berries contain a red and very 
•our juice, that is beneficial in chronic dysentry, or diarrhoea; 
also, as a cooling drink mixed with water, sugar, and orange 
peel, or cinnamon bark ; it is useful in fevers for abating heat 
and quenching thirst. A syrup may also be made from the 
berries or bark ; or a tea may be made of the bark, mixing cin- 
namon or allspice to suit the taste, and give a wine glass, cold, 
every three hours. The bark or berries added to hard cider, 
and used freely three times a day, are recommended in disease! 
ef tae Liver, 




Aralia Racemosa, or Common Spikenard. 

(the boot.) 

This grows in deep woods and good soils, from New England 
to the far South and West. The root is a healing pectoral, stimu* 
lant cordial, and causing gentle perspiration. It is much used 
by the Indians ; the roots bruised, chewed, or pulverized is used 
by them in all kinds of sores, bruises, and ulcers. In coughs 
and colds the root may be used freely, boiled in syrup ; or it 
may be used as a tea, cold, mixed with flaxseed- tea, lemonade^ 
or toast-water, when the cough is troublesome. A little piec* 
of the root chewed and the juice swallowed is also beneficial in 
allaying a tickling cough 



39 




Cvrnus Sericea, or Rose Willow* 

(the bark.) 

This growa near brooks, along the banks of rivers, a? d on upland 
Beadows ; it is known throughout the United States by vhe name of red 
rose-willow, which distinguishes it from the olaclc willow, or the pu&» wil~ 
lew, which grows in swamps, and along the sides of moist meadoves. It is • 
powerful astringent and tonic — preferred by some to the Peruvian bark or 
Columbo Root, and is much employed in the Northern States, in snbstanct 
Of otherwise, in diarrhoea and dyspepsia. In vomiting, this is an avceHen* 
fwnedy, given in the form of an infusion ; in the vomiting puttlwUH* 
arising from pregnancy. This is a valuable article. It is inwtlj artinW 
iftored in the form of infusion, or tea, given cold. 



40 




Asclepias Tuberoaa f or Pleurisy Moot. 

(the root.) 

This is a valuable popular remedy, and a mild sudorific (causing sweat 
ing) acting safely, without producing any stimulating effect upon the body. 
Its action is specifically upon the lungs, to assist suppressed expectoration, 
and to relieve the difficult breathing of patients laboring under plearisy. 
It relieves difficulty of breathing and pains in the chest. It sometime* 
acts as a mild purgative, and is suitable to the complaints of children. 
In low stages of typhus fever, and other diseases of a like nature, it hai 
been known to excite perspiration when other medicines have failed. 

Fron twenty grains to a drachm of the root, in powder, may be given 
•everal times & day ; but as a diaphoretic (to produce sweating), it is bea* 
given in decoction or inmsion (tea), made in the proportion of an ounce U. 
ifee quart of water, and given in the dose of a teacupful every two at 
three hours till it operates. 






41 




Hatris, or Devil's Bit, 

(THB BOOT.) 



Tanacetum Vulgare, or Tanseff 

(THE LEAVES.) 



Liatris ; or, Devil's Bit. (The Root.) The root of this plant has a bitterish, pun- 
gent, spicy taste, and smells like turpentine or juniper. It is a powerful diuretic (acting 
on the kidneys) yet acting mildly, and may he used freely without danger ; it also act! 
m a diaphoretic, producing perspiration ; and is also a tonic, strengthening the system; 
ft is also good bruised, and applied to ulcers, sores, etc It is a useful medicine in 
iropsy, sore throat, gravel, scrofula, etc. A wine-glass full of the tea, or infusion 
(cold) ; given every three hours, is good to operate on the kidneys, or taken warm tc 
produce perspiration ; or three times a day (cold) before meals as a tonic ; or ten grain* 
of the powder may be given three times a day in syrup. 

Tanacetum Vulgare ; or ; Tansey. (The Leaves.) This grows in moist pasturvj 
•dge of cornfields, and is cultivated in gardens. Given in the form of tea, warm, k*l 
not too strong, it produces perspiration freely, and is good in debilitated persons ; t 
wine-glass may be taken, cold, three times a day in dropsy, hysterics, and diseasa cf 
th* kidneys. It is good taken warm to exnel wind from the stomach. 



42 




Aspidium Filix Mas» 9 or Male Fern. 

(the root.) 

This plant grows in shady pine forests from New Jersey to Virginia j 
it is likewise a native of Europe, Asia and North of Africa. It is used 
as a remedy against tape worm. Dose of the powdered root from one 
to two teaspoonfuls, given with powdered white sugar, white of egg 
beat up, or the thick juice or water of slippery elm ; this dose to be re 
peated night and morning for two days ; then give a brisk purgative of 
castor oil, and should that not operate in three hours, give a dose o* 
Epsom or Rochelle salts 



43 




Cassia Senna, or Alexandria Senna* 

(THE leaves ) 

This is a very useful cathartic, operating effectually and 
■uldly. It is necessary to combine this article with other in- 
gredients, such as manna, aniseed, etc., to prevent its griping 
effects. It is often administered, principally in the form of in- 
fusion. Infusion of Senna is made thus : Take of Senna leaves, 
an ounce and a half; ginger root, sliced, a drachm; aniseedt 
or caraway seeds, a drachm ; boiling water, a pint. Maeerat* 
(keep warm) for an hour in a covered vessel, and strain the 
liquor. Take one half for a dose, the balance to be takeD is 
three hours if necessary. 



u 




Arislotochia Serpentaria 9 
or Virginia Snake Boot, 



Aeelepias Syrlaca, •* 
Common Silk Weed. 



Arislotochia Serpentania ; or, Virginia Snake Root. (The Root.) This was first 
Introduced as a remedy against snake bites, from which it derives its name, and was used 
by the Indians for that purpose. It possesses powerful and lasting stimulant virtues; 
eut besides this general action, it acts also on the skin, producing perspiration. It ia 
?ery useful in all cases where there is not active inflammation, in promoting perspiration, 
especially in typhoid fevers, etc. Dose of the powder, ten to twenty grains, in syrup 
•r flaxseed-tea ; or it may be used as an infusion (or tea), which is preferable, putting 
half an ounce to a pint of boiling water ; of which four or five tablespoonfuls may be 
fiTNt every three or four hours. 

Asolspiab Striaoa ; or Common Silk Weed. (The Root.) This plant, growim 
plentifully throughout the United States, along roadsides and sandy grounds, is a pow 
erful diuretic (operating on the kidneys), and is useful in dropsy. Boil eight ounoes of 
Ike root in six quarts of rain water down to three quarts ; strain before using. Fot 
dropsy, take a gill of this deeoction four times a day, increasing the dose, or otherwise, 
according to the symptoms. It is used the same way for suppression of urine. It may 
t» taken ia powder, twenty V> thirty grain* three times a day. 



45 




Crocus Sativus, or Garden Saffron. 

Ik small closes, saffron is employed as a diaphoretic, soon causing per- 
•piration ; in large doses, it acts upon the whole animal economy in the 
same way as a stimulus. It extends its action considerably to the uterus, 
(wonb.) It is useful to allay the lumbar pains (in the back) which ac- 
company menstruation in some females. It is aeeful also in cl^orosis or 
jreen sickness, hysterics, &c. It may be employed likewise as a stomachic 
(or eordial) and antispasmodic (for spasms, &c.) 

Dose— In powder, twelve grains. To make an Infusion, pat half it 
one drachm, in one pint of boiling water; let stand half an hour; give a 
wine glass full every two hours. It is very valuable in all eruptive distasea 
isch as measles, small pox, dec. 



46 




Hyoscyamtis Niger, or Black Henbane* 

(THB plant.) 

Thjs is an annual plant, native of Europe, but growl 
plentifully in this country, along road-sides and among rubbish, 
flowering in July. This plant applied externally, made into a 
poultice or fomentation, is useful to allay pain in all cases of 
obstinate and painful inflammations, such as boils, fistulas, eore 
throat, and swelling of the breast. The dose and manner of 
administration, internally, will be found under the head of 
Medicines, their doses and uses; and also in the treatment 
of various forms of diseases treated of in this work. 



47 




Scutillaria Laterifolia, or Scull Cap, 



(thb plant.) 



This is found in all parts of the United States, in meadowy 
woods, near water, &c., flowering in the summer. It is highly 
recommended for St. Titus' Dance, given in the foii» of tea, 
(cold,) a wine glass full, or more, three times a day on an 
empty stomach. Given in the same way, it is highly re 
commended also for worms, to he followed the third day bv » 
purge it castor oil. 

The plant or leaves may also be powdered, axid given ii 
of from ten to fifteen grains three timet a day. 



48 




Papoose Root {Blue Cohosh). Common 
in most parts of the United States, growing 
in moist, rich woods. The root, the part 
used, has a sweetish, pungent taste, useful 
in rheumatism, dropsy, epilepsy, hysterics, 
cramps, irregular and painful monthly sick- 
ness. Strong tea, a wine-glass full or more. 
Tincture, half to one teaspoonful thvee 
times a day. 



Golden Seal.— An American plant of 
great value as a medicine, the root only 
being used, and is a fine tonic, good in dys- 
pepsia, typhoid fever, intermittent fever and 
when convalescence sets in after serious 
diseases. Fluid extract, half to two tea- 
spoonfuls three times a day, Also as a gar- 
fle, in sore throat, mixed with extract of 
lue cohosh and witch hazel, one tablo- 
spoonful of mixture with one of honey and 
powdered alum in a pint of warm water, 
used frequently. 




' Mountain Laurel {Big Ivy). Not safe 
for internal use, but when the dried leaves 
are powdered and mixed with flaxseed or 
slippery elm, they make a good poultice for 
boils^ ulcers, sores, &c. 



Conium Maculatum {Poison Hemlock). 
Not safe for internal use except prescribe! 
by physicians. 



49 




Cinchoka Tree.— From this is gathered 
the Peruvian Bark, of which the Quinine 
is made, and is one of the most valuable 
medicines known to man. 



Ceanesbill. -Grows in open woods In all 
parts of the United States, the root only 
used. A powerful astringent, good to make 
a gargle in sore throat, or to make a wash 
for ulcers, sores, &c, or to use for an injec- 
tion for female weakness (whites), &c, or 
powdered, is good to mix in poultices for 
boils, sores, &c. Not much used internally. 




Blue Flag.— The root, the part used ; it I 
acts on the bowels, kidneys and glands. 
It must be used with care. Dose, of the 
tincture, one to two teaspoonfuls. 



Slippery Elm.— The inner bark makes A 
fine poultice ; useful put in water as a drink 
in fevers, coughs, diseases of the kidneys* 
bladder, and for dysentery in children, &c 



50 




Pipsissewa {Prince's Pine). This is an 
astringent tonic and diuretic (acting on the 
kidneys). All the plant can he used. A 
wineglass full or more of the tea (cold) three 
times a day. 



STAB GRASS {Unicorn Poot, Ague Root % 
Crow Corn) . An American plant, and val- 
ued highly as a medicine. A fluid extract, 
given in doses of ten to twenty drops, three 
times a day, is prescribed in cases of pain- 
ful menstruation, dyspepsia, falling of the 
womb, &c. A tincture can be given in doses 
of one or two teaspoonfuls three times a 
day, instead of the fluid extract. 




TTva Ursi— Grows in Europe, Asia and 
America. Berries do not mature till winter, 
but flowers appear June to September. The 
part used is the leaves. In diseases of the 
kidneys and bladder, thought to be valuable 
In urinary gravel, painful urine, and chronic 
inflammation of the bladder, kidneys, &c. 
A strong tea, cold, a teaspoonful three 
times a day. It is tonic and astringent. 



Ginseng.— Used principally as a pleasant 
article of personal use, for chewing, much 
better and safer than tobacco. The Chinese 
used to pay fabulous prices for it. John is 



ettiog wiser. 



51 




Bayberrt.— Grows in damp places. The 
bark of root used. Ground or powdered, 
and mixed with flaxseed or slippery elm, as 
a poultice to tumors, ulcers, &c. Strong 
tea, cold, as a wash for spongy gums, had 
fereath, sore mouth, and diseases of the 
•kin. A stringent and stimulant. 



Witch Hazel.— Th's has fruit and flow- 
ers on the same hush at the same time. A 
valuable American vegetable tonic, Ac. Is 
now principally used in the form of Extract 
of Witch Hazel, and to be had at the drug 
stores, with directions for use. 




Mandrake {May Appie\ The root. It 
acts finely on the liver, and is one of the 
most valuable American indigenous plants. 
A solid extract, made into half grain pills, 
to be had of druggists, are very convenient 
to have in the house. Dose, usually one 
half grain pill at bed-time. 



Bitter Root.— A plant growing in mos* 
parts of the United States ; is a good, gen- 
tle purgative, alterative and tonic. Make a 
strong tea, and use cold, taking a wineglass 
full before each meal, in cases of syphilis, 
disease of the liver, scrofula, and general 
debility. 



52 




Hobbhound.— Too well known as a valu- 
able medicine for coughs, colds and sore 
throats, as a syrup, gargle, etc., to need any 
recommendation from us. 



Chamomile (The Flowers). A tonic for 
weak stomachs ; good to mix with poulti- 
ces ; often used in form of tea (cold) for 
dyspepsia, wind on the stomach, &c. 




STRAMONIUM {Jamestown Wood, Stink- 
wood, Thorn Apple, &=c.) Not fit for inter- 
nal use by any but physicians. This is a 
deadly poison. 



Poke Root.— A valuable American medi- 
cal plant. An extract made from the root, 
in doses of one to three grains, three times 
a day, is given for mercurial and syphilitic 
diseases, rheumatism, Ac. A valuable poul- 
tice is made by putting the root into hot 
ashes until soft, then applied to felons, &c. 



53 




Skunk Cabbage,— A fluid extract made 
from the root and given in doses of twenty 
to sixty drops three times a day is useful in 
cases of asthma, whooping cough, bronch- 
itis, hysterics, nervousness, &c. 



Tapioca.— This is used as an article of 
food ; is very digestible and nourishing for 
convalescents. The plant grows in Brazil 
and the West Indies, and the root is the 
only part used. 




Ladies' Slipper.— The fibrous roots only 
used, for nervous headache, nervous excita- 
bility, hysterics, neuralgia, and pains in 
various parts of the body, the fluid extract 
being the best form to give It in ; dose, one- 
lialf to two teaspoonfuls three timed a day. 



Lobelia —The leaves and seed are often 
used in spasmodic asthma, whooping cough 
croup, and bronchitis. It must be used with 
caution, from ten to thirty drops of the 
fluid extract being a dose, as needed for 
loosening a cough, &c. 



54 




ELACX SNA-T3-TioOT {Black Cohosh). Is 
found in many parts of the United States ; 
the root only part used. Tincture, dose, 
one to two teaspoonfuls three or four times 
a day. Is useful in many forms of nervou3 
diseases, such as St. Vitus' Dance, Nervous 
Excitability, Asthma, Delirium Tremens, 
&c. It moderates the action of the heart, 
and is often used in chronic rheumatism. A 
good, medicine. 



Pink Root.— A valuable medicine lor 
expelling worms. Make a strong tea, half 
an ounce of the root to a pint of water, and 
take when cold from two to six ounces, ac- 
cording to age, on an empty stomach, for 
three or four successive mornings, and then 
follow by a brisk purge of castor oil. 




Buchu.— A valuable plant, growing at the 
Cape of Good Hop 2, the leaves only being 
used. Valuable in all diseases of the urin- 
ary organs. A tea made of the Buchu, and 
used cold three times a day, a wineglass or 
two with a little spirits nitre in a convenient 
form. Fluid extract, one to three teaspoon- 
fuls three times a day, is preferred by some. 



Belladonna. {f%ualy Night Shade). A 
valuable medicine in the hands of the phy- 
sician, but principally valuable to families 
in scarlet fever (which see). 



55 




ACONITK (Monkshood Wolfsbane).— Five 
drops of the fluid extract, In three ounces 
of water ; mix, and take one teaspoonful 
every hour or two. Useful in f ever3, inflam- 
mation, rheumatism, &c. 



Prickly Ash.— The bark and berries are 

used ; an extract (fluid) or tincture in doses 

of fifteen to fifty drops three times a day, is 

good for rheumatism, di4eases of the liver, 

I and syphilitic diseases, nervousness. &c. 




Camphor Tree.— Growing in the East 
Indies. The use of camphor gum and spirits 
of camphor is too well known to need any 
description. 



Marsh Mallow.— Now made into candy 
drops, caromels, &c. A good tea can be 
made from the root in cases of coughs, 
colds, &c. 



56 




Fox Glove.— An European plant, and 
valuable in the hands of physicians, but too 
powerful for general use. American Helle- 
bore is now ~ery often used instead of Pox 
Glove. 



Capsicum {Cayenne Pepper). Its name 
and uses are as familiar as household words 
but still it is a valuable article to have about 
the house, being a diffusive stimulant, either 
as a tincture, in water, or made into a tea. 




Ntrx Vomica.— From this is made the 
deadly Strychnine, not safe to be used ex- 
cept in rare cases, and by experienced phy- 
sicians ; but makes a first-class dog killer. 



Dog WooD.—The bark only. Is a good 
tonic, and often used instead of Feruvian 
Bark in fevers. A tea, cold, wine-glass or 
two before each meal acts well in many 
cases of general weakness. 



THE 

BEST FAMILY PHYSICIAN. 



HOW TO PRESERVE HEALTH. 

The variety of temperaments or constitutions renders if 
possible for health to be very different in different persons 
hence what would preserve the health of one would occasion 
disease m another. Persons of a sanguine temperament, whose 
-"«5sels are full, and whose fibres are firm and active, easily ex- 
cited to motion, and often to irregular actions, bear evacua- 
tions well ; and have their health best promoted by abstinence 
and low living, by avoiding excess of every kind, and particu- 
larly guarding against cold after active bodily exertions. Tho 
bilious temperament, with a constitution more acutely sensible, 
always more i/ri table, requires the same precautions as the 
sanguine ; but the evacuations best adapted, which are indeed 
almost indispensable to this kind of constitution, are the free 
and frequent use of the milder laxatives. To preserve the 
health of the melancholic, of those whose complexion is dark, 
and whose powers are torpid, whose mind is dull, but perseve- 
ring, much exercise is required to assist digestion and to turn 
the circulating fluids to the skin. From the torpor of the 
bowels, to which persons of this temperament are peculiarly 
liable, they will demand the occasional use of purgatives of 
the alcetic kind ; their occupations and amusements should be 
varied and interesting to the mind. The phlegmatic temper- 
ament is pale in complexion, languid in its exertions ; the 
vessels, if full, are torpid, the constitution inactive; the 
mind not easily excited to exertion. The diet in this tem- 
perament, requires to be nutritive and somewhat stimulating, 
though it ought not to go the length of what would be callecY 
high living. 

The health of females has some peculiarities arising from 
the delicacy of their frame, the monthly discharge, the state 
of pregnancy, and of nursing. All these circumstances coo* 

57 



58 Sow to Preserve Health. 

stitute a condition very different from the robust and vigor* 
ous strength of man in the prime of life ; yet equally perfect, 
relatively to the sex and the individual. The irritability of 
infants, and the nimble tricks of boyhood, are consistent with 
good health, though they would be unsuitable at a more ad* 
vanced period of life. 

Health varies in people of different occupations. The acute* 
■Bess of the senses which is necessary in some employments* 
would be morbid in persons otherwise engaged. But some 
Lave various diseases or predispositions to disease, either de- 
rived from parents or acquired in the progress of life, which 
render health with them only a comparative term. The scrof- 
ulous can hardly be said in strictness ever to be in perfect 
health ; but their disease may be dormant or undeveloped ; 
and, in favorable circumstances, may permit the subject of it 
to enjoy an exemption from pain and inconvenience, to the 
end of a long life. Gouty and rheumatic patients ma^ also 
enjoy good health during the intervals of their attacks. 

AIR. 

Atmospheric air, or that by which we are usually surround* 
ed, is not a simple, but a compound body, consisting of at least 
four distinct substances, viz : oxygen, azote, carbonic acid, and 
aqueous, or watery vapor. 

The two former substances, however, constitute almost the 
whole of the atmospheric air near the surface of the earth ; 
the other two are variable in their proportions ; the first ex- 
ists only in minute quantities, which it is difficult to appre- 
ciate. Vital air, or oxygen, which constitutes about one-fourth 
of the atmosphere, is necessary to respiration and combustion, 
and an animal immersed in it will live much longer than in 
the same quantity of common air. The remaining three- 
fourths, called azote, or mephitic air, is totally incapable of 
supporting life or combustion for an instant. 

The oxygen which is received into the lungs of animal? 
from the atmosphere, communicates the red color to the 
blood, and is the principal agent which imparts heat and 
activity to the system. When animals die for want of oxy 
pen in the air, their blood is always found black. Independ* 
ectly of its destruction by the respiration of men and othei 
animals, there is a constant consumption of the oxygenoun 
portion of atmospheric * air, by the burning of combustible 
bodies ; by the fermentation and putrefaction of vegetable 
substances, etc 



Air. 59 

A diminished proportion, therefore, of the oxygen of ouf 
atmosphere, and an increased amount of carbonic acid and 
other deleterious gases, is undoubtedly produced from the 
innumerable processes of combustion, putrefaction, and res- 
piration of men and animals, particularly in populous cities, 
the atmosphere of which Is almost constantly prejudicial to 
health. 

In the open country there are few causes to contaminate 
the atmosphere, and the vegetable productions continually 
teud to make it more pure. The winds which agitate the 
atmosphere, and constantly occasion its change of place, waft 
the pure country air to the inhabitants of the cities, and dis- 
sipate that from which the oxygen has been in a great meas- 
ure extracted. The air of any place where a numerous body 
of people is assembled together, especially if to the breath 
of the crowd there be added the vapor of a great number of 
candles, lamps, or gas-lights, is rendered extremely prejudi. 
cial, as these circumstances occasion a great consumption of 
oxygen. 

The tact is well known, that when air has been long con- 
fined and stagnated in mines, wells, and cellars, it becomes 
80;extremely poisonous as to prove immediately fatal to those 
who imprudently attempt to enter such places. No person 
should descend into a well or cellar, which has been long 
closed, without first letting down a lighted candle; if it burns 
clear there is no danger, but if it cease to burn, we may be 
sure that no one can enter without the utmost danger of 
immediate suffocation. It sometimes happens also, that when 
air is suffered to stagnate in rooms, hospitals, jails, ships, &c, 
it partakes of the same unwholesome or pernioous quality, 
and is a source of disease. It is obvious, therefore, that in 
all confined or crowded places, the correcting of vitiated air, 
by means of cleanliness and frequent ventilation, is of the 
highest importance to health, and the most effectual preser- 
vative from disease. No accumulation, therefore, of filtli 
about our houses, clothes, or in the public streets, should oti 
any pretence be suffered to continue, especially during ths 
heat of summer. 

It is a very injurious custom for a number of persons to 
occupy or sleep in a small apartment, and if it be very close, 
and a fire be kept in it, the danger is increased. The vapor 
of charcoal, when burnt in a close apartment, produces the 
most dangerous effects. Our houses, which are made close 
and almost air-tight, should be ventilated daily, by admitting 
a free circulation of air to pass through opposite windows • 



60 Air. 

iind our beds ought to be frequently exposed to the influent 
of the open air also. 

Houses situated in low marshy situations, or near lakes o* 
pouds of stagnant water, are constantly exposed to the infla 
euce of damp and noxious exhalations. 

Among the most powerful means furnished by nature fot 
correcting air which has become unfit for breathing, is the 
growth and vegetation of plants. Animal bodies consumi 
oxygen, and give off carbonic acid; plants and vegetable* 
oonsume carbonic acid, and give off oxygen. The generality 
of plants possess the property of correcting the most corrupt 
air within a few hours, when they are exposed to the light of 
the sun ; during the night or in the shade, however, they 
destroy the purity of the air, which renders it a dangerous 
practice to allow plants to vegetate in apartments occupied 
for sleeping. 

Marshes. — The neighborhood of marshes is peculiarly un- 
wholesome, especially towards the decline of summer and 
during autumn, and more particularly after sunset. The air 
of marshy districts is loaded with an excess of dampness, and 
with the various gases given out during the putrefaction of the 
vegetable matters contained in the waters of the marsh. Per- 
sons exposed to this air are liable to various diseases, but espe- 
cially ague, bilious fevers, diarrhoeas, and dysenteries. They 
who breathe it habitually exhibit a pallid countenance, a 
bloated appearance of the abdomen and limbs, and are affected 
with loss of appetite and indigestion. Health is best pre- 
served in marshy districts by a regular and temperate life-- 
exercise in the open air during the middle of the day, and by 
retiring as soon as the sun sets, within the house, and closing 
all the doors and windows except enough for ventilation. The 
sleeping apartment should be in the upper story, and rendered 
perlectTy dry by a fire, lit a few hours before going to bed, 
and then extinguished. Exposure to the open air should, if 
possible, not take place in the morning before the sun 
has had time to dispel the fog, which, at its rising, covers the 
Eurface of the marsh. Persons who are intemperate, or use 
ardent spirits habitually, are those most liable to suffer from 
the unwholesome air of marshes ; such generally perish from 
diseases of the liver and dropsy. 

Night Air. — Many diseases are brought on by impruden 
exposure of the body to the night air ; and this, at all seasons. 
in every climate, and variety of temperature. The causes of 
this bad property of the night air, it is not difficult to assign, 
The heat ie almost universally several degrees lower than ii 



Air. 61 

ihe daytime ; the air deposits dew and other moisture ; th« 
pores of the skin are open, from the exercise and fatigues of 
the day ; the evening feverishness leaves the body in some 
degree debilitated and susceptible of external impressions; 
and from all these concurrent causes are produced the various 
effects of cold acting as a check to perspiration ; such as 
catarrhs, sore throats, coughs, consumptions, rheumatisms, 
asthmas, fevers, and dysenteries. In warm climates, the night 
air and dews, with their tainted impregnations, act with much 
malignancy. In civilized life, and in crowded towns, how 
many fall victims to their own imprudence, in exposing them- 
selves to the cold, the damp, and the frostiness of the xiight 
air! Issuing from warm apartments with blazing fires, or 
from crowded churches, theatres, or ball-rooms, with exhausted 
strength, profuse perspiration, thin dresses, and much of the 
person uncovered, how many are attacked with a benumbing 
cold and universal shivering, which prove the forerunners of 
dangerous inflammations of the brain, of the lungs, or of the 
bowels, which either cut them off in a few days, or lay the 
foundation of consumption or other lingering illness. Never 
stand to talk, even for a moment, in the open air, after coming 
out of a heated or crowded room, or after active exercise. 
Such being the dangers of exposure to the night air, it ought 
to be inculcated on all, both young and old, to guard against 
them, by avoiding all rash and hasty changes of place and tem- 
perature, by hardening the frame by due exercise and walking 
in the open air in the daytime ; and on occasions where the 
night air must be braved, taking care to be sufficiently 
clothed ; and to avoid drawing in the cold air too strong or 
hastily with the mouth open. Always breathe through the 
nostrils for a short time after going out of a warm room into 
the cold air, keeping the mouth shut. 

Sea Air. — The air upon the sea and in its neighborhood is 
generally distinguished by its greater coldness, purity, and 
sharpness ; and is therefore in many cases directed to patients 
whose complaints do not affect their respiration, and who have 
vigor of constitution enough to derive benefit from the stimu- 
lus which such air occasions. A residence by the sea-side i» 
beneficial to persons of a scrofulous habit and debilitated con 
stitution, provided they take care not to expose themselves to 
cold and damp ; and in the fine season, when there is no 
reason against it, they ought to bathe. In complaints of the 
chest, the use of sea-bathing, and a residence near the sea, are 
more questionable ; and by such an inland rural situation, in 
a mild equable climate, is to be preferred. A sea voyage hai 



62 Air. 

long been famous for its good effects at the commencement trf 
consumptive complaints ; and these good effects may be as 
scribed partly to the good air at sea, partly to the affection of 
the stomach and skin induced by sea-sickness, and to the ex 
titement of the mind, caused by change of scene and occupa- 
tions. 

Ventilation. — The air, as we have already remarked, can 
not become stagnant or unchanged for even a short period 
without its becoming unfit for breathing, and destr active to 
the hetlth of those who breathe it. Tne streets of a city 
should therefore, be so laid out as tc insure a constant and 
free circulation of air ; hence the unwholesomeness of a resi- 
dence in narrow alleys, courts and passages. Not less impor- 
tant is the continued renewal of the air of our apartments — 
the ventilation of which, however, should be so conducted as 
to prevent a current of air from blowing directly upon the 
persons within them. Our bed-chambers, in particular, should 
be freely ventilated during the day ; and even at night, when 
the windows are closed, the chimney should be left open, or, 
if the room is small, and the weather sultry, a door, opening 
into another room, or a window partly open, or the sash pulled 
down to admit fresh air. "No consideration of economy should 
prevent the most constant attention being paid to proper ven- 
tilation, so essential is the latter to health and comroit. 

Cellars. — It is important that cellars should be perfectly 
dry, kept strictly clean and freely ventilated. The damp and 
foul air so frequently generated in cellars, where dryness, 
cleanliness, and ventilation are not properly attended to, is 
often the cause of disease, not only in the persons who inhabit 
the house to which the cellar is attached, but in others resid- 
ing in the immediate neighborhood. No house can be con- 
sidered a healthy residence, in the cellar of which water is 
allowed to stagnate : this may easily be obviated, in most situ- 
ations, by a sink dug to gravel. The air of cellars can b<a 
preserved sufficiently dry and wholesome by free ventilation, 
the removal of all filth and corruptible materials, and fre- 
quently white-washing the walls. Cellars, especially when 
entirely under ground, are improper places of residence ; ap- 
propriating them as places of residence for the poor, or as 
workshops, should be prohibited by law. 

Climate. — Climate is considered by physicians, not with 
reference to geographical situation, but to the state of regioni 
as to the warmth and steadiness of their temperature, or the 
dryness or moisture of their atmosphere. The interior of con 
tinents and islands is generally mountainous, and, in cons©- 



Clothing. 63 

quenee, cold. From the bracing qualities of the prevailing 
winds, the inhabitants are robust, and disposed to Mamma 
tory diseases : invalids, or persons coming from warm climates, 
•hould ; therefore, prepare themselves gradually for mountain 
ous regions, by not coming abruptly into those colder parts. 

CLO THING. 

Clothing possesses no warmth in itself, but merely prevents 
the heat ot the body from being carried off by the air, and 
other surrounding bodies, faster than it »an be supplied by the 
blood. The essential requisites for clothing are, that it be soft 
and pliable, so as not to obstruct the free and easy motion of 
the joints, or occasion inconvenience by its weight or tight- 
ness ; that it be adequate to protect the body from the external 
influence of the atmosphere, and preserve it in that degree of 
temperature which is most agreeable, as well as best adapted 
to the exercise of its different healthy functions and motions ; 
and that it does not produce any detrimental effects, occasion 
any unnecessary degree of perspiration, or absorb the vapors 
of the atmosphere. Clothes of a light color, have the least 
attraction for heat; those of a black, the greatest; the first 
mentioned are, therefore, most proper in hot, the last in cold 
weather. 

But besides these general properties of commodious and 
comfortable clothing, it should be suited in quantity and ma- 
terial to the climate, the season of the year, the period of life, 
the constitution, and the habits and mode of living. Thus, a 
person who is engaged in a sedentary employment, will always 
require warmer clothing than one who is actively engaged in 
manual, or other labor demanding considerable muscular ex- 
ertion ; and the latter will always require an addition of 
clothing, the moment he has ceased from his active labors, to 
what is proper whilst engaged in them. Neither do young 
persons, or those in the prime of lite, and in robust health, 
require clothing in the day, or covering in the night, of so 
warm a nature as persons advanced in years ; because the per- 
formance of their functions is more equal and vigorous, and of 
course, the generation of heat in the body is quicker, and of 
greater extent, than is the case in old age. 

One of the safest rules in the regulation of dress, is to adjust 
ft iD the vicissitudes or fluctuations of the season; and thii 
rule should be carefully attended to by the invalid, the delicate, 
the infirm, and the old. The winter clothing should not be 
left off too early in the spring, nor the summer clothing worn 
too late in the autumn. Neither should this rule be disregard 



64 Clothing, 

ed by the young, and those in the enjoyment of perfect health 
The grand rule is, so to regulate the clothing, that, when ex 
posed to the external air, the difference of temperature 
experienced, shall not be such as to produce any unpleasant 
impression, whatever may be the inclemency of the weather, 
when we go abroad. Thinner clothing are necessary withia 
doors than without, and a greater warmth of clothing after 
night, and during cold, damp weather, than during the day^ 
and when the air is perfectly dry. 

Persons of delicate and irritable constitutions, whose powers 
of life are feeble, and whose circulation is languid and irregu- 
lar, are very apt to suffer severely by a very slight diminution 
of the temperature of their skin. This is also the case with 
invalids. All such persons, therefore, ought rather to exceed, 
than be deficient in the quantity and warmth of their clothing. 

But while clothing should not be too light, or too small in 
amount, neither should it be too heavy, or too much in quan- 
tity. The effects are equally mischievous. By over-clothing, 
too much perspiration is drawn out of the body, by which the 
frame is greatly weakened, and coldness and numbness of the 
extremities are occasioned. 

Tight clothes are invariably detrimental to the health, com- 
fort, and symmetry of the body. By the pressure they make 
upon the muscles, and the impediment they offer to their free 
exercise, they produce in them an emaciation and debility 
which prevent them from supporting properly the natural and 
graceful position of the body, or effecting its active movements 
with sufficient vigor. They prevent also, the free circulation 
of the blood, and cause it to accumulate in the veins of the 
head, lungs, or abdomen. When the pressure of the clothes, or 
any part ot them, is around the neck, it is apt to produce head- 
ache, discoloration of the face, giddiness, and apoplexy, or 
other diseases of the brain ; when upon the chest and waist, it 
prevents the full development of the lungs, impedes breathing, 
and interferes with the proper action of the heart, in conse- 
quence of which, the health of the whole system suffers ; when 
around the abdomen, the stomach, liver, and bowels are affect- 
ed, and indigestion is produced, or the nutrition of the whole 
body is rendered imperfect. The clothes, therefore, should be 
perfectly loose, leaving to every part the fullest liberty, and to 
all their natural and unconstrained motions. Avoid muffling; 
up the neck, head, ears, &c, when in good health. This is all 
important at every period of life, but particularly so, during 
infancy and childhood. 

The skni of a child, from the neck downwards, ought to b* 



Clothing. 65 

fcept warm by proper clothing; bare legs and chests, thin and 
insufficient clothing cause croup, inflammation of the lungs, 
&c. Keep flannel or woolen next their skin in cold weather. 

Flannels or Woolens worn next the skin, in addition to 
the ordinary clothing, are of very great service in preserving 
the health. They produce a moderate warmth of the surface, 
promote perspiration, readily absorb the perspired fluids, and 
easily part with them again by evaporation, on account of the 
porous nature of their texture. Woolens should be worn at all 
ieasons by the aged, and all subject to diseases of the chest or 
bowels, and by invalids. 

Flannel is also well adapted for infants and young children, 
especially in autumn, winter, and spring. Older children do 
not require it, excepting during the cold weather, and all 
persons under forty, in good health, should reserve it as a re- 
source for their declining years, during which it becomes every 
year more and more useful and necessary. Flannel that has 
been worn during the day, ought not to be habitually worn 
at night, but exchanged for a woolen night shirt. Always 
wear the same kind of materials next the skin at night as you 
do in day time. Many persons who wear woolen under-gar- 
ments during the day time, sleep in a cotton night shirt, and 
thereby greatly impair their health. Flannels need to be 
washed often. 

Such persons as find flannel too irritable to their skin, may 
obviate this, by having it lined with thin muslin. We especi- 
ally recommend the use of flannel drawers to females. 

Cotton. — Cotton, as an article of clothing, especially when 
worn in contact with the skin, is far better adapted for gene- 
ral use than linen, but is inferior to woolens. In warm weather, 
and in hot climates, it is the most comfortable article for an 
iiiner dress. It is cooler than linen, inasmuch as it conducts 
more slowly the excess of external heat to our bodies, and 
vhen a sudden reduction of atmospherical temperature occurs, 
on the other hand, it abstracts more slowly the heat from the 
body, and thus preserves the surface of a more steady and 
uniform temperature. 

Linen. — Whatever may be said in favor of the comforts of 
linen, and the greater ease with which it is kept clean, it is by 
no means a substance well adapted for the dress worn next te 
the skin, at any season of the year, nor by any class of persons. 

Head Dress. — Whatever covering is worn upon the head 
should be light, sufficiently large, and adapted in its form to 
the shape of the head. Too heavy or warm a covering, or one 
which compresses unduly the head, is productive of pain and 



(y& Clothing. 

inconvenience. In summer, the color of the hat or bonnet 
should be white, or at least some shade approaching to white, 
in consequence of the tendency of all dark colors to absorb ana 
transmit the rays of heat. *fhe brim of the hat should also 
be sufficiently broad to protect the face and eyes from the sun. 
Although the nature of a head dress may appear to be a sub 
iect of very little importance in regard to health or comfort, 
yet every one has perhaps experienced more or less of the pain 
and inconvenience, occasioned by wearing a new hat, too small 
in the crown, and unfitted in shape to the head, and the almost 
immediate relief which results from exchanging it for one of 
more ample dimensions. 

Cravat. — It is important that of whatever it is composed, it 
be very light and loosely applied. When the neck is kept too 
warmly coversd, it is very injurious ; the throwing off of the 
cravat 'for a few moments, or exchanging it for one of lighter 
materials, will often give rise to a violent inflammation of 
the throat. Cravats and neck ties must not be worn too 
tightly ; this is often the cause of a "horrible headache." 

Corsets and Tight-lacing. — Of all the whims of fashion, no 
one is more absurd., or more mischievous in its effects, than 
that which condemns the female, under the pretence of im- 
proving the grace and beauty of her shape, to the torture of a 
tightly laced corset. Equally detrimental to comfort and to 
health, this portion of female attire cannot be too severely cen- 
sured. It is productive of not the least advantage, real or 
imaginary, to compensate for the injury it produces, nor to 
excuse the folly of females in persisting in its use. The im 
mediate effect of tight-lacing is, by compressing firmly the 
chest, to prevent its free expansion in the act of breathing ; a 
less amount of air is taken into the lungs, and as a consequence, 
the blood is less perfectly changed. The impediment to 
breathing is increased when the corset extends so low as to 
compress the abdomen ; by the bowels being then forced up- 
wards against the diaphragm, (or partition between the chest 
and abdomen,) the latter is prevented from descending, and 
the dimensions of the chest are thus contracted from below. 
A sense of oppression and weight is always experienced about 
the breast when the corset is drawn very tight around the 
body ; the breathing is short, quick, and panting ; and no fc 
only is the blood prevented, in a great measure, from under 
going that change in the lungs by which it is adapted for tli@ 
Healthy nourishment of the various organs, but the actions o3 
the heart are also impeded ; violent palpitation is not unfre- 
quentiy produced, accompanied with a sense of giddiness and 



Clothing. 67 

occasional fainting. When the corset is worn constantly from 
earvy youth, the growth of the ribs is prevented, and the whole 
capacity of the chest is permanently contracted ; and hence 
spitting of blood, difficulty of breathing, or even more dan 
gerous and fatal diseases of the lungs and heart are induced. 
Consumption is a very common complaint, the production or 
aggravation of which may be traced to tight lacing. But it is 
not merely to the chest that the injurious effects of the corset 
are confined ; it likewise compresses the whole of the upper 
portion of the abdomen (or bowels,) and by the yielding na- 
ture of this portion of the body, the pressure upon the organs 
within is even more considerable than that experienced by the 
heart and lungs. The liver, the stomach, and the bowels in 
particular, experience this pressure to a very great extent ; in 
consequence, the free and healthy secretions of the liver are 
prevented from taking place, the stomach and the bowels can 
no longer perform their functions with proper vigor and regu- 
larity ; the digestion of the food is impeded, and the bowels 
become costive and distended with wind. In this manner, in 
connection with the injury inflicted upon the lungs, the vigor of 
the whole system becomes prostrated, the skin assumes a sal- 
low hue, the countenance a haggard and wrinkled appearance, 
and all the functions of life are performed imperfectly. It is 
a fact, that nothing is better adapted to produce the pre- 
mature decay of beauty, and the early appearance of old age, 
than tight-lacing. 

There are two other effects produced by this article of dress, 
which would be sufficient of themselves to induce every pru- 
dent and sensible female to abandon it. The first is the 
great injury inflicted upon the breasts, by which their proper 
development is prevented, and the nipple is almost entirely 
obliterated, so that, when called upon to fulfil tka sacred office 
of nurse towards her offspring, the mother finds, to her sorrow, 
that, from her folly, she has totally incapacitated herself front 
performing its duties, or experiencing its pleasures. The 
second effect is that produced by the pressure of the corset upon 
the pelvis (hips) and the womb, more especially when worn in 
early youth, or during the first stages of pregnancy. From 
this cause barrenness, miscarriages, or a stunted and "deformed 
offspring may result, or the pains, the difficulties, and the 
dangers of child-birth, may be increased to a frightful degree 
Let no American woman talk about the Chinese women com 
pressing their feet to prevecx siiern from growing, so long asf 
^he continues the life- destroying custom of tight-lacing. 

Garters. — Tight garters are injurious by impeding the cii 



68 JBxercise. 

enlation of tlie blood in the leg. Swelling and nuxtibnew of 
the leg, and permanent enlargement of the veins of that limbv 
are consequences of wearing tight garters. 

EXEH C ISB. 

By this means disease may often be prevented, and not 
nnfrequently cured, even when it has taken a very strong hold 
npon the constitution. Generally speaking, a slothful and 
sedentary life is the source of all those diseases which ara 
termed slow or chronic, the number of which is in our day 
very considerable. 

The exercise which is necessary to the maintenance of the 
health, vigor, and the perfect and full development of the 
human frame, is such as will bring into action every limb and 
muscle ; this is termed active exercise, and is produced by the 
exertions of the body in walking, running, and various speciee 
of labor. 

The chief kinds of passive exercise are, riding, swinging, 
and rowing. To derive all the advantage resulting from exer- 
cise, it must be regular. Little benefit need be expected, 
when, to occasional exercise of the muscles, a long period of 
inaction succeeds. Exercise, to be beneficial, must also be in 
the open air, and should never be carried to the length of 
inducing undue fatigue. The other general rules in regard to 
exercise, may be laid down as follows : — 

The effect of exercise should be as general as possible, and 
not confined to any particular limb or part of the body, aa 
walking, running, riding on horseback, etc. 

Little benefit is to be expected from exercise, unless it be 
performed in a pure air. 

The higher and drier the situation, and the more varied the 
air in which exercise is performed, the more beneficial will be 
its effects. 

On commencing any exercise, we should always begin with 
the more gentle, and then proceed to the more laborious : and 
as sudden transitions are always wrong, the same rule should 
be followed when exercise is given up. 

A good appetite after exercise, is a proof that it has not 
been carried to any improper excess. 

It is a good rule, frequently to vary the exercise. 

Lord Bacon correctly observes, it is requisite to long life, 
that the body should never abide long in one posture, but 
every half hour at least, should change it, except during 
sleep. 

Muscular motion is most agreeable and healthful, when tht 



Exercise. 69 

ftom&oh h neither too empty, nor too much distended. Active 
exercise is improper, therefore, immediately after a meal, or 
after long fasting. 

Nothing can be more injudicious than to sit down to a sub- 
stantial dinner or supper, immediately after a fatiguing walk, 
ride, or other violent exertion. Every man should rest for 
some time after exercise, before he sits down to eat. 

In taking exercise, the dress should be free and easy, paiv 
ticularly about the neck and joints. 

In violent exercises, a flannel waistcoat ought to be wora 
next the skin, to obviate the possibility of injury from a sud- 
den chilling of the surface of the body. 

It will always 0e found very refreshing, after fatiguing exer- 
cise, to wash the feet in tepid water, before going to bed. 

Serious thinking, when we are walking or taking other 
exercise, soon fatigues us ; but if we give ourselves up to 
amusing thoughts, or the conversation of agreeable and intel- 
ligent friends, the good effects resulting from exercise are 
increased. 

It is very desirable to have a certain object or spot by 
which the exertion is to be bounded. Exercise undertaken 
Merely as a task, or without being connected with some pur- 
pose by which the mind is agreeably occupied and excited, ia 
seldom productive of much advantage. 

Walking. — There is no exercise so natural to us, or in every 
respect so conducive to health, as walking. It is the most 
perfect kind of exercise in which the human body can be 
employed ; for by it every limb is put in motion, and the cir- 
culation of the blood is effectually carried on, throughout the 
minutest veins and arteries of the system. 

Walking is of two kinds, either on plain ground or where 
there are ascents. The latter is in every respect greatly pre- 
ferable. Walking against a high wind is very severe exer- 
cise, and not to be recommended. 

As, from various circumstances, persons residing in large 
towns, and engaged in sedentary occupations, cannot take all 
that exercise abroad, which is necessary for their health, thev 
ought, at least as much as possible, to accustom themselves to 
walk about, even in their own houses, instead of sitting coa* 
etantly at a desk or table. 

The following rules are recommended to the attention of 
those who make use of this excellent species of exercise : 

The most proper walk, for health, is in a pure and dry air, 
and in rather an derated situation, avoiding marshy and 
damp places. 



70 Exercise. 

In the summei season, the walk should be taken morning 
and evening, but by no means during the middle of the day, 
tmless the person be guarded from the oppressive heat of the 
tun. In winter, the best period of the day for walking is 
usually after breakfast, or from ten to one o'clock. 

It is advisable, occasionally, to change the direction of the 
walk. 

We ought to accustom ourselves to a very steady and 
?egular, but not to a very quick pace ; in setting out, it should 
be rather slower than what we afterwards indulge in. 

An agreeable companion during a walk contributes much 
to serenity of mind ; but unless the manner of walking of both 
is similar, as well as the taste and character congenial, it ft 
better to walk alone. 

To read during a walk is highly detrimental to the eyes, and 
destroys almost all the good effects that can be derived from 
the exercise. 

Swimming. — For the young, the robust, and healthy, swim- 
ming is an excellent recreation. It combines all the advan- 
tages to be derived from bathing, with active exercise of 
nearly every part of the body. Swimming, however, as well 
from the powerful and constant exertion it demands, and the 
coldness of the water in which the body is immersed, is im- 
proper for the debilitated, or those exhausted at the time from 
fatigue. 

Riding. — Next to walking, riding on horseback is the most 
salutary and useful species of exercise, especially for invalids. 

Persons laboring under ill health, whether occasioned by 
too long continued sedentary habits, or from defective diges- 
tion, as well as those predisposed to consumption, will expe- 
rience from the exercise of riding the most decided advantage. 

In riding to preserve health, eight or ten miles a day are 
Euffic?ent to answer all the purposes ; but, in riding to restore 
health, these little excursions will avail nothing. To attain 
the latter object, the mind, as well as the body, must be 
roufted from its languor. Upon this account, long journeys 
are recommended to such people, in order, by the variety or 
novelty of the scenes through which the invalid passes, to 
awaken or divert the mind. Many have, by these mean* 
been surprised into health. 

Rowing. — Rowing a boat, to those who are not daily accus* 
tomed to the task, may be ranked among the most activ* 
species of exercise. To the robust and those in perfect health 
this exercise, when not carried to the extent of producing 
very considerable fatigue, is one admirably calculated to im 



Appetite. 71 

part str eng th to the arms, and breadth and development to the 
chest. When, however, it is too frequently repeated, to the 
neglect of other species of exercise, it is very apt to produce 
a partial and ungraceful expansion of the frame. 

F motion. — Friction of the skin, in conjunction with regular 
bathing, forms a very important means of preserving and im- 
proving the health of the body. It removes thoroughly from 
the surface every species of impurity which may accidentally 
adhere to it, and promotes the freedom of the blood's circula- 
tion in the minute vessels of the skin. It promotes the growth 
and development of the muscles — invigorates the digestive 
organs, and imparts a comfortable glow and an increased 
energy to the whole system, by which it is rendered less liable, 
during cold and changeable weather, to become affected with 
disease. 

Though useful to all, frictions are peculiarly adapted to in- 
crease the health and vigor of persons of debilitated habits, 
who lead a sedentary life, are subject to dyspepsia, gout, and 
rheumatism, or who are particularly liable to be affected by 
cold by slight variations of the weather. Their whole bodies, 
more particularly their limbs and the front part of the body, 
should be rubbed for a few minutes, morning and evening, 
with a flesh-brush or coarse towel, until the surface begins to 
grow red, and assumes an agreeable glow. In many cases, 
sponging the body with cool or tepid water, will be found to 
increase the good effects to be derived from the practice. It 
is preferable to the too-often repeated and much abused plung- 
ing into a bath-tub, which is practised to a great extent at 
present, in cities especially. Frictions are highly useful in 
the case of delicate females ; and in children they promote 
their growth and activity, and prevent many of the diseases 
to which they are liable. 

The best time for using friction is in the morning, when the 
stomach is not distended with food. They who are subject to 
wakefulness and disturbed sleep will hnd, in addition to a 
properly regulated diet and active exercise in the open air, 
that sponging the body with tepid water, followed by brisk 
frictions of the surface, will more effectually induce quiet re- 
pose than any other means. 

AE PETITE* 

These are three kinds of appetite: 1st. The natural or 
healthy appetite, which is stimulated and satisfied with tha 
most simple food ; 2d. The artificial appetite, or that excited 
by condiments, liquors, pickles, high-seasoned dishes, variety 



72 Appetite. 

of food, wine, &c, and which remains only so long m th« 
operation of these stimulants continues : 3d. The appetite of 
habit, or that by which persons enjoying no inconsiderable 
health, accustom themselves to take food at stated hours, but 
frequently without relishing it. The true and healthy appe- 
tite alone can ascertain the quantity of food proper for the 
ndividual. If we were seldom to trespass the due limits of 
^mperance, our natural appetite would be able accurately to 
determine how much food we may consume with satisfactioa 
and benefit, but the age we live in is one of intemperance in 
eating as well as everything else. If, after a meal, we feel 
ourselves refreshed, and as cheerful as before it, or more so, 
we may be assured that we have taken no more than a proper 
quantity of food ; for, if the right measure be exceeded, tor- 
por, heaviness, and relaxation, are the necessary consequences ; 
our digestion will be impaired, and a variety of complaints 
gradually induced. 

Hunger. — As a general rule, the sensation of hunger sh®uld 
as seldom as possible be allowed to occur ; for, although the 
old proverb, " hunger is the best sauce for our food," is true, 
if the term hunger be used merely to signify keenness of ap- 
petite • yet, the moment it becomes a painful sensation, the 
stomach and other organs suffer, and the energies of the sys- 
tem are, to a certain extent, prostrated. 

Abstinence. — Abstinence from food, for a limited period, is 
often, during health, of very great importance ; it is one of the 
most powerful means of obviating the effects of any accidental 
excess, of warding off an impending attack of disease, and of 
removing those disorders of the stomach, incident upon the 
introduction into it of food of an improper kind. Occasional 
abstinence from food, by omitting a meal or two, or substitut- 
ing for an animal diet, a bowl of gruel, or a slice of bread and 
tea, restores the force of the digestive organs, by diminishing 
their action, and giving them rest, and time to resume theu 
healthful energies ; while, at the same time, when the system 
is rapidly verging into disease, or the vessels are overloaded 
with blood, it removes from the first a stimulus which might 
increase its deviation from health, and upon the second, it acts 
as an evacuant, by allowing the secretions time to remrre 
from them their excessive amount of fluids. The studious, n» 
well as they who lead sedentary lives, are especially oenefited jf 
occasional abstinence ; as such persons, from the want of sut 
ficient exercise, are generally the severest sufferers from 
diseases of repletion, and from a disordered state of the dige» 
tive organs. 



Appetite. 73 

Food. — Excess of food, even of the lightest and most whol© 
lome kind, interrupts digestion, oppresses and irritates ths 
stomach, produces a feverish heat of the surface, loads the 
vessels witn an excess of blood, and when sufficient exercise is, 
not taken, renders the body unwieldy, by the accumulation of 
fat beneath the fckin, and around the internal organs. Partak- 
ing of a great variety of food at one meal, is injurious ; it 
causes more to be eaten than is proper, and impedes th 
digestive powers of the stomach. With respect to the solid or 
fluid nature of our tood, a certain degree of solidity assists its 
digestibility; soups, jellies, gravies, and the like, are more 
readily digested, when bread or other solid substance is added 
to them, than when they are eaten alone. A sufficient hulk 
of food in the stomach, to give it a gentle stimulus and dis- 
tension, is absolutely necessary for healthy digestion : it is on 
this account, that all condensed articles which contain much 
nutriment in a very small space, are unwholesome. In regard 
to the concentration of food, very erroneous and injurious 
opinions generally prevail. It is supposed, by most persons, 
that by extracting the nutritious principle or principles of any 
given article of food, they are able, with greater certainty and 
effect, to nourish the body of the sick and delicate ; thus, we 
continually hear of strong beef-tea, pure arrow-root jelly, and 
the like, being prepared with great care for such persons. 
But many of our readers will be much surprised to hear, that 
dogs and other animals, fed on the strongest beef-tea, or pure jelly 
alone, rapidly emaciate, and die within a short period, and 
that precisely the same consequences would ensue, were the 
strongest man confined to the same food. A certain bulk, 
therefore, of food taken into the stomach, is essential to nutri- 
tion ; and all attempts to combine too much nutriment in too 
small a mass, materially impairs the wholesomeness of our 
food. 

Vegetable Food. — Although vegetable food requires ft 
longer time to digest in the stomach than animal, and not- 
withstanding the latter presents a larger amount of nutritive 
matter in a smaller bulk than the former ; yet the human sys- 
tem can derive from vegetable food as great a quantity of 
suitable nourishment as from animal, while the former pro- 
duces much less excitement and heat, and is far less liable to 
produce over-fullness of the blood-vessels, or to predispose the 
organs to disease. As a general rule, it ^rill be found that 
they who make use of a diet, consisting chiefly of vegetable 
»ubetances / properly cooked, such as rice, oatmeal, potatoes 
&c, have a manifest advantage in looks, strength and spirit^ 



74 Appetite* 

over those who partake largely of animal food ; they are re» 
markable for the firm, healthy plumpness of their muscles, 
and the transparency of their skins. The diet of children, and 
young persons generally, should consist almost exclusively oi 
vegetables and milk. In summer, and in warm climates, a 
greater proportion of vegetable food is required than in winter 
and in cold climates. They who, with a sufficiency of daily 
exercise in the open air, to preserve the activity of the diges- 
tive organs, nevertheless spend ordinarily a life of ease and 
comparative inaction, will find their health and comfort better 
promoted by a diet principally vegetable, than by animal 
food. Towards the decline of life, though, the amount of ani- 
mal food should be gradually increased. 

Animal Food. — Man is destined to live upon both animal 
and vegetable food, and a proper combination of both con 
Btitutes the aliment which, generally speaking, is best adapted 
to his taste, and the one by which the health and vigor of hi i 
system is under most circumstances best sustained. 

The nourishment communicated by both animal and veg(* 
table food is much the same; but the animal product is the 
most easily separated by the digestive organs, and is afforded 
in the greatest amount. The blood of the individual who par- 
takes largely of animal food, is richer than the blood of those 
fed principally upon a vegetable aliment. The first gives, 
Likewise, a greater tendency to inflammatory affections than 
the latter. For those who are accustomed to active and la- 
borious employments, a greater amount of animal food will be 
proper than for the sedentary and inactive. Infants require 
less animal food than children, children than adults, and wo- 
men than men. In summer, the quantity of animal food should 
always be diminished, whatever may be the habits or occupa- 
tions of the individual. In winter, and in the more northern 
climates, a more permanent and stimulating nourishment is 
required than under opposite circumstances : this is best afford- 
ed by animal food. The different kinds of animal food differ 
in the degree of nourishment they afford, as well as in tha 
ease with which they are digested. Thus, the flesh of full- 
grown animals is much more digestible and nutritious than 
that of their young ; and as it respects the larger animals, this 
rule is without exception. Beef and mutton, for example, are 
more easily digested, and more wholesome than veal and lamb. 
The %ex of animals, too, influences the nature of the food ; 
the flesh of the female being more delicate than that of the 
male. The mode of killing, too, gives a tenderness to the 
flesh. Hunted animals are more tender than those that ai« 



Appetite. 75 

killed on the spot. The flesh of animals which are allowed to 
range freely in the open air, is more wholesome and nutritious 
than of such as are stall-fed. In general, the flesh which is 
dark colored, and which contains a large proportion of fibrin, 
is more digestible and nutritious than the white flesh of ani- 
mals. The black meat of fowls, so called, is more nourishing 
than the white meat, (the breast, &c.) Thus, the flesh of do- 
mestic fowls is not so readily dissolved in the stomach as that 
ef the different kinds of game. By cooking, animal food is 
changed in its texture, being generally rendered softer, and 
easier of digestion ; but by improper modes of cooking, a re- 
verse effect is produced, the food being rendered indigestible, 
unnutritious and unwholesome. 

Varieties of Animal and Vegetable Food. — Gelatine, or 
animal jelly, is highly nutritious ; but in its separate or 
concentrated state, it is difficult of digestion ; hence, the im- 
propriety of the dyspeptic, and persons of weak stomachs 
generally, being fed upon strong soups, calves' feet jelly, and 
similar articles of food. 

Calves' Feet Jelly. — Plain calves' feet jelly, or that which 
is sweetened, is grateful to the palate, very nutritious, and not 
very difficult of digestion ; it is sometimes a useful article of 
diet for convalescents ; it may be taken cold, or dissolved in 
warm water, according to circumstances. It should, however, 
only be given occasionally, or in moderation ; for jelly, like all 
other concentrated food, is not so readily converted into blood, 
as many other articles which contain a less amount of nutri- 
ment. The addition of wine and spices to the jelly, renders 
if. an improper article of diet under most circumstances. 

Albumen. — The purest example of albumen is that presented 
by the white of the egg ; it nevertheless enters largely into the 
eomposition of many of the animal fluids and solids. As an 
article of food, it is at once readily converted into blood, it 
i eing taken up by the absorbent vessels, without its being re- 
quired to undergo digestion, while at the same time it is 
highly nutritious. The injurious effects resulting from the 
eating of hard boiled eggs, are occasioned in a great measure 
by the effects of the heat upon the oily matter of the yolk. 

Milk. — This is one of the most valuable presents which a 
bountiful providence has bestowed upon man. In many in- 
stances, either alone, or in combination with vegetables, it has 
formed the sole sustenance of life — maintaining fully the health 
and robustness of the system, without any of the disadvantagea 
which result from an excess of animal food on the one hand, 
or the diminished strength and vigor which have been sup- 



76 Appetite. 

posed to be the effect of a purely vegetable diet, on th« 
other. 

Incalculable would be the benefits which would result to 
the working and laboring classes of our country, were they U 
substitute this wholesome and nourishing food in their fami 
lies, for the expensive and unnutritious slops, which, under 
the name of tea or coffee, constitute the chief of their morning 
and evening meals ; or, to substitute a tumbler of milk for the 
pernicious dram of ardent spirits, beer, porter, or ale. 

For children, milk with bread, or a simple preparation of 
milk with rice, or with eggs and sugar, is perhaps the best and 
most wholesome food that can be devised : it should, at least, 
form the principal part of their nourishment for the first few 
years of their life. 

Milk, to be perfectly wholesome, should be drawn from 
sound, young animals, supplied with a sufficiency of their na- 
tural food, and allowed free exercise in the open air. The 
best mode of using it, is, undoubtedly, in its raw state, and 
when it has stood about two hours after being drawn. 

Eggs. — Eggs contain a great deal of nourishment in a small 
bulk : and when perfectly fresh, and soft boiled, they consti- 
tute a species of food of very easy digestion. When hard 
boiled, and especially when fried, they are indigestible and 
stimulating. 

Cheese. — All kinds of cheese are of difficult digestion ; and 
can with safety be made use of, only in very small quantities, 
as a condiment along with other food. The idea entertained 
by many, that a portion of old cheese taken with the desert 
aids digestion, is perfectly absurd. When cheese has advanc- 
ed very near to a state of putrefaction, though eaten by certain 
epicures, it is at once disgusting to the senses, and injurious to 
the stomach. Certain changes which cheese occasionally un- 
dergoes, impart to it poisonous properties. Roasted or cooked 
cheese, is very indigestible, and liable to occasion painful sen- 
sations in the stomach, headache, sour belchings, feverish heat 
of the skin, and disturbed sleep. When eaten, cheese should 
always be combined with a large portion of bread. 

Butter. — Butter is used as a sauce to many articles of food, 
and is frequently added to flour to be baked into cakes and 
pastry, and it is in both these forms injurious, for though it 
does not produce effects that are immediately apparent, it layg 
the foundation of stomach complaints of the greatest obsti- 
nacy. Its use in this form is also very apt to give rise to 
diseases of the skin, very difficult to cure. Persons laboring 
under stomach complaints should not use much butter in any 



Appetite. 77 

form. It is also very unwholesome when heated. It is a had 
part of the management of children, to pamper their palatea 
oy frequently indulging them with butter ; as it is apt to give 
rise to a gross and unhealthy habit of body, characterized by 
the frequent appearance of boils and other sores, discharges 
from behind the ears, &c, or eruptions on the head, and other 
parts of the skin. 

Fat affords a rich nutriment, requiring, however, strong 
powers of digestion, and adapted only to the healthy and la- 
borious ; it is more wholesome, however, when eaten with 
a proper quantity of lean, or with a considerable addition 
of farinaceous aliment in the form of potatoes, bread, rice, 
&c, &c. 

Beef. — Beef affords a strong, easily digested, and whole- 
gome nourishment ; it should be tender, fat, and well mixed, 
(lean and fat) and taken from a bullock of middle age. 

Of its different parts, the fat is less easily digested than the 
lean ; the tongue and also the tripe, being of a more dense 
texture than the other parts, are more indigestible. The best 
mode of preparing beef, is by roasting, or boiling. Beef-steaka 
appear to be the form, however, in which its nutritious quali- 
ties are best retained. 

The excessive body of fat which is accumulated upon what 
is called prize beef, adds nothing to its goodness, but on the 
contrary, renders it less wholesome and nutritious. 

Mutton. — Mutton is a highly nutritious and wholesome meat. 
It appears to be the most digestible of all animal food. The 
flesh of the male animal, however, has in general so strong 
and disagreeable a taste, and is, besides, so exceedingly coarse, 
and difficult of digestion, that it is only adapted to persons of 
strong digestive powers. Ewe-mutton, if it is more than be- 
tween three and four years old, is likewise tough and coarse. 
Wether-mutton, or the flesh of the castrated animal, is most 
esteemed, and is by far the sweetest and most digestible. 

Lamb being less heating, and less dense than mutton, is bet- 
ter suited to persons convalescent from acute diseases ; but by 
the majority of patients laboring under indigestion, or any- 
other severe affection of the stomach, it is not found so diges 
fcible or proper a diet as wether-mutton. It is, however, to 
£ ^rsons in health, a light and wholesome food, especially when 
the lamb is not killed too young. A lamb that has been al 
lowed to suck five or six months, is fatter and more musculan 
and in every respect better, than one which has been killed 
when two months old, and before it has had time to attain ita 
proper consistency. 



78 Appetite, 

Yenison, — The flesh of the deer is reckoned a great delict 
ey ; it is nutritious, savory, and easy of digestion. 

Veal. — The flesh of the calf, like that of all young animals, 
abounds in gelatinous matter ; it is far less easy of digestion 
*han the flesh of the ox, or beef. For persons in health, the 
most proper mode of cooking veal is by roasting or baking. 

Teal Broth produces a laxative effect upon the bowels 
and is a very suitable food for persons troubled with costive 
mess. 

Pork. — Good porlc is unquestionably a very savory food, 
and affords strong nourishment, well suited, as an occasional 
diet, to persons who lead an active or laborious life ; but it is 
not easily digested, nor can it be considered so wholesome as 
beef or mutton. The too frequent and long continued use oi 
this meat favors obesity or fatness, and is apt to disorder the 
stomach and bowels, and occasions pimples or boils upon the 
skin. 

Bacon. — It is a strong, very indigestible, and stimulating 
food, adapted only to persons of robust frame, and accustomed 
to laborious occupations. The best mode of cooking bacon is 
by boiling it with vegetables. When fried with eggs, it ia 
decidedly unwholesome. 

Ham. — When properly cured, and when boiled, ham is a 
fery palatable and wholesome food. Ifc is, however, stimulat- 
ing and difficult of digestion, and only suited to such persons 
as are in full health and exercise much in the open air. Fried 
ham is still more indigestible than that which is boiled. 

Sausages. — In whatever form they are eaten, sausages are 
an indigestible and unwholesome food, fitted only for the 
stomach of the most robust. When sausages have been long 
kept, particularly in a damp place, they are apt to undergo 
certain changes, in consequence of which they become poi- 
sonous. 

Poultry. — Poultry, in the common acceptation of the term, 
includes all the domesticated birds used as food, as the common 
fowl, turkey, duck, and goose. In point of digestibility they 
rank nearly in the order we have enumerated them. 

Chicken Soup. — Chicken soup, when properly prepared, id 
a light food, adapted to many invalids and to persons conva* 
lescent from fevers. For their use it should be prepared from 
the fleshy or lean parts of the chicken, well boiled in water 
with a little salt, the scum and fat being taken off as it rises. 

Fish. — Fish are less nutritious than the flesh of warm-blood 
ed animals, while to most stomachs they are more difficult of 
digestion. When used habitually, they are apt to induce di* 



Appetite. 79 

eases of the skin and disorders of the bowels. The fat offish 
is still more indigestible than that of other animals, and 
readily turns rancid on the stomach. When not in season, all 
kinds of fish everywhere, are very indigestible an'd unwhole- 
some. The best mode of cooking fish is by boiling ; stewed 
or fried fish are very indigestible. Salted and dried fish are 
ft still more unwholesome food than such as are eaten fresh, 
Butter and the acid fruits form improper sauces for fish, caus- 
ing it almost always to oppress and irritate the stomach : nor 
should fish and milk ever be taken at the same meal ; this com- 
bination has frequently occasioned severe bowel complaints. 

Salt-water fish are the best. Those fish which have scales 
are, in general, the most easily digested, and the best. 

Salted Meat. — Salted meat is more difficult of digestion 
than that which is eaten fresh ; it is also less nutritious, both 
from the pickle in which it is immersed washing out, as it 
were, a considerable amount of its nutritive parts, and from 
the chemical change which it always undergoes to a greater 
or less extent. "When used as food, salted meat should always 
be well boiled, and eaten with a large quantity of vegeta- 
bles. 

Crabs and Lobsters, in whatever manner cooked, are indi- 
gestible and decidedly unwholesome. 

The Mussel, a shell-fish often used as food, is highly 
indigestible and unwholesome. 

Oysters, when taken raw or after being slightly cooked by 
roasting, are a i ight, nutritious, and easily digested food. 
The hard white part, or eye, should always be rejected. When 
thoroughly cooked, particularly when stewed or .fried, oysters 
constitute, on the other hand, one of the most indigestible and 
pernicious articles of food in ordinary use. When out of sea- 
son, oysters are always unwholesome. The juice of the oyster, 
thickened with grated biscuit and warmed, is sometimes an 
3xcellent diet for persons laboring under great delicacy of 
tomach. 

Soups. — For the laboring classes generally, there is scarcely 

more wholesome and economical article of diet than soup. 
We allude now to the ordinary domestic soups, prepared from 
beef, mutton, or veal, with the addition of various vegetable* 
In the preparation of soup, the meat and vegetables should ba 
well boiled, and whatever seasoning is added to increase the 
flavor, care should be taken that it be not thereby rendered 
loo stimulating. The combinations of flour and butter, which 
are sometimes met with in soups, under the denomination of 
iumplings, are highly indigestible and improper. Soup should 






80 Appetite. 

always be eaten with plenty of bread ; this gives it that degree 
of consistency which, in all our food, appears to cause it to 
oe the most readily acted upon by the stomach. 

Many suppose that soups generally are calculated only for 
those whose powers of digestion are weak ; but this is a mis- 
take, the reverse being generally the case. When the digestive 
powers are weak or deranged, it will almost always be found 
that solid food agrees the best, particularly solid animal food ; 
this the stomach seems to digest with ease and in a very short 
time ; whereas, liquid food is apt, in such cases, unduly to di»> 
tend the stomach and to require a greater strength of digestive 
power. 

Rice. — When mixed with other food, it furnishes a whole- 
some article of diet. Rice is supposed to be in some degree 
astringent ; and in looseness of the bowels, the water in which 
it has been boiled forms an excellent drink. By its mild mu« 
cilaginous properties, it aids greatly also in allaying irritation 
in all diseases of the bowels. 

Oats. — The meal obtained by grinding the grain of oat» 
affords a wholesome and nutritious food, used boiled with wa- 
ter, in the form of gruel, or made into thin cakes. 

Gruel. — By gruel is generally understood oat-meal or 
Indian meal boiled in water. Thin plain oat-meal gruel, or a 
gruel made in the same way from Indian meal, is a useful 
diet for convalescents from fevers, and for those who have 
committed an excess in eating. 

Rye affords a meal, the food prepared from which, though 
less nutritious than wheat, is nevertheless wholesome and suf- 
ficiently nourishing. Rye bread is more difficult, however, of 
digestion, and is apt to turn sour in the stomach and to irritate 
the bowels. 

Barley. — Barley forms an excellent article of nourishment 
when boiled in water, or made into cakes. Barley bread is 
not, however, a very pleasant nor wholesome food. 

Barley-water. — The water in which barley is well boiled, 
forms one of our best drinks, in various fevers and other dis- 
eases. 

Maize, or Indian Corn. — The meal made by grinding 
Indian corn, prepared in various ways, but especially when 
made into mush, or with the addition of wheat flour bake* 
into bread, furnishes a most wholesome, nourishing, and pal 
atable food, and one well adapted for the support of the active 
and laborious generally. Indian bread, properly prepared, 
were it not from habit and fashion, would recommend itself to 
•rery palate by its agreeable flavor, and the beauty of its ap- 



Appetite. 31 

it is far preferable to the ordinary bread mada 
from wheat alone. To make this bread, a mush should be 
made of the Indian meal in the usual way ; into this, when 
cold, with the addition of a very small quantity of warm water, 
and a little salt and yeast, is to be kneaded a sufficiency of 
wheat flour to make it into a paste ; when sufficiently raised, 
*t is tc be again kneaded, and baked in the same manner as 
bread. 

Bread.— New bread is particularly unwholesome and indi- 
gestible. The only apparent exception is in the case of new 
rolls, which healthy stomachs manage to digest pretty well, 
provided they be well baked, and the crust bears a consider- 
able proportion to the whole. 

Bread slightly toasted, but not burned, is a wholesome diet, 
especially for persons upon whose stomachs most articles 01 
vegetable food, including bread in its ordinary state, are apt 
to turn sour. In eating toast, the butter should not be spread 
upon it until it is cold. 

Panado. — The crumb of wheaten bread softened with boil- 
ing water. It forms an excellent diet for children ; for those 
affected with fevers, and for women during the first days after 
delivery. 

Ginger-bread. — When well baked, and eaten in modera- 
tion, it affords, under many circumstances, a useful stimulus to 
the stomach. It is an excellent article for individuals going to 
sea ; it being frequently, in cases of sea-sickness, retained on the 
Btomach, when every other article is immediately rejected. 
Travelers, also, on setting out early in the morning, will find, 
that eating a small portion of it, will afford a grateful stimulus 
to the stomach, when they have been obliged to coinuaence 
their journey without breakfasting. 

Pastry, or dough mixed with butter, is used in a great 
variety of forms, and though grateful to the taste, is highly 
indigestible, and injurious to health. At dinner, in the shape 
of pies and tarts, pastry is thrown into the already loaded 
stomach, and the over-taxed powers of that organ are unable 
to digest what is difficult to manage when they are the most 
vigorous. To children, pastry is peculiarly unsuitable ; they 
who use it much, are subject to runnings from the ears, dis 
orders of the bowels, eruptions on the skin ? and inflammatory 
complaints of various kinds. 

Puddings, when composed of flour, or crumbs of bread, 
combined with suet and dried fruit, are extremely indiges- 
tible, and constitute v^o of the most unwholesome diehef 



82 Cookery. 

served at meals. Puddings and dumplings made of batter, 
baked or boiled, are also indigestible, and unwholesome. Bread 
and milk pudding, as well as rice pudding, is readily digested, 
and may be eaten in moderation, without injury. 

Sago, boiled with water, or milk, furnishes an agreeable and 
nourishing jelly; it is easy of digestion, and excites the 
system but little ; and is an excellent article of diet for con- 
valescents and for children. 

Potatoes constitute an article of diet, which, whether we 
have reference to the nourishment it affords, the agreeablenesa 
e€ its flavor, its wholesome qualities, and the extent to which 
it is consumed, is certainly of the greatest importance to man. 
Potatoes are the lightest and most nutritious of those vege- 
tables which are served at table in their natural state; and, 
next to bread, the very best accompaniment to every kind of 
animal food. The dry, mealy kinds are the best, and should 
always be preferred to those which are hard and waxy. The 
best manner of cooking the potato, is by boiling in two waters, 
or by roasting. Finely mashed, or fried potatoes, are indiges- 
tible and oppressive to the stomach. 

Cabbage affords but little nutriment, is very flatulent, and 
where the stomach is delicate or irritable, it is very apt to 
produce uneasy sensations, cholic, &c. Boiling in two waters 
deprives it, in a great degree, of that unpleasant taste and 
smell, which are so disagreeable to many palates. 

Soukckotjt forms an excellent and wholesome vegetable 
food for the crews of ships destined for long voyages ; and for 
all persons so situated as to be deprived of a sufficient supply 
of fresh vegetables. In regard to its effects upon individuals, 
whose powers of digestion are impaired, the same remarks will 
apply as to cabbage in its recent state. 

COOKERY. 

When meat is boiled too long or too fast, if it contains much 
albumen, as in beef, we shall obtain a hard and indigestible 
mass, like an over-boiled egg ; or in young meats, such as veal^ 
where there is more gelatine, the result will be a gelatinous 
substance, not easily digestible. Young and viscid food, 
therefore, as veal, chickens, &c, are more wholesome when 
roasted than when boiled, and are easier digested. Boiling k 
very properly applied to vegetables ; as it renders them more 
soluble in the stomach, and deprives them of a quantity of ail 
and other particles which are pernicious to weak stomachs 
The quality of the water used in boiling requires some atten 






Cookery. 83 

lion ; mutton boiled in hard water is more tender and juicy 
than when soft water is used, while hard water renders vege- 
tables harder and less digestible. 

Roasting. — By this process, the fibre of meats is made crisp 
the fat melted, and the water evaporated. When underdone 
roasted meat may be more nourishing; but, from the close- 
ness of its texture, it will not be so easily digested. Meat 
loses more by roasting than by boiling ; by boiling, mutton 
loses one-fifth, and beef one-fourth ; but by roasting, they loss 
one-third of their weight. 

Feting is, perhaps, the most objectionable of all the opera- 
tions of cookery. The heat is applied through the medium of 
boiling oil or fat, which is rendered scorched, and therefore 
extremely liable to disagree with the stomach. 

Broiling.-— By this operation, the sudden browning or hard- 
ening of the burface prevents the evaporation of the juices of 
the meat, and imparts a peculiar tenderness to it. But the 
over-excited health brought on by eating meats thus cooked, is 
peculiarly liable to become changed into disease from very 
slight causes. 

Baking. — Baked meats are not so easily digested on account 
of the greater retention of their oils. Such dishes, accordingly, 
require the stimulus of various seasonings to increase the di- 
gestive powers of the stomach. As there is often much pastry, 
made with butter, used to confine the juices of the meats baked, 
euch accompaniments render meat pies of all kinds of food the 
most difficult of digestion. 

Stewing has a similar effect to boiling in depriving the meat 
of much of its nourishing juices ; but as the Huid in which the 
meat is stewed is made use of as food in connection with the 
latter, little nourishment is absolutely lost by this mode of 
cooking. Stewed meat is less easily digested than that which 
is boiled ; it is also more stimulating. Simple stewing is a 
mode of cookery well adapted for the food eaten by those of 
•obust frames and laborious habits. 

Meals. — Regularity in the number of meals, and the period? 
at which they are taken, is of the first importance \ on it mucb 
of the equable and pleasant enjoyment of health depends. In 
general, three meals, in the course of the day, seem the most 
desirable, and the best adapted to the wants and constitution 
of the human frame ; while, at the same time, this number ii 
6est suited to the powers of the digestive organs. 

The practice which leaves the great bulk of the day without 
a meal, and then crowds two or three together, is manifestly 
Dad, as it produces in the body a state of exhaustion and fa- 



84: Cookery. 

tigue, which strongly tends to enfeeble the powers of digestion 
To confirm and preserve health, whatever maybe the numbei 
of meals taken, they should be eaten at regular times and stat- 
ed periods. Six o'clock dinners, are only another way oi 
destroying health, and shortening life. The extremes of too 
Jong fasting, and too frequent repletion, should be carefully 
avoided ; for the langor of exhaustion and the fever cf reple- 
tion, are equally injurious to the healthy state of the stomach: 
its muscular fibres are debilitated by excess ; while a collapsed 
■tate of the organ occasions its loss of tone and energy, and 
superinduces constitutional weakness. And it should be re- 
membered, that one meal should be duly digested before the 
introduction of another into the stomach. 

Breakfast. — During sleep, the whole of the food taken the 
previous day has probably been digested ; but, in general, it 
is proper to interpose some time between rising and taking 
breakfast, and take some light exercise. 

Dinner. — The period for dining appears to be well choseD 
for the active classes of society more especially. Dinnei 
should always consist of one kind of meat, plainly cooked. 
Variety of food, like too much seasoning, keeps up the appe- 
tite after the wants of the system are satisfied ; the stomach is 
oppressed by too great a quantity of food, and digestion is im- 
peded even to a greater extent than were the same amount to 
be eaten of a single dish. Let it be recollected, also, that 
dishes compounded of a number of ingredients, the natural 
qualities of which are completely disguised, by the refinements 
of cookery, are altogether unwholesome : many of them are 
little better than poisons. It is all-important that sufficient 
time should be allowed for this meal, in order that the food 
may be properly cheiued, without which its digestion will ba 
greatly retarded. If the food be sufficiently plain and juicy, 
thirst will seldom be experienced ; but when a desire to drink 
is experienced, a moderate draught of water will be proper. 
But no other liquor should be taken — water is the only natural 
diluent of our food, every other liquor impedes its digestion. 
The custom in use among some people of taking drams or bit- 
ters before meals, for the purpose of whetting the appetite, is 
highly pernicious, and has quite a contrary tendency to that 
designed, as it relaxes the stomach, and consequently enfeebles 
t for the operations it has to perform. Nor is the fashion of 
taking wine, or brandy and water, during dinner, less repre- 
hensible. The use of bottled cider, porter, or beverage, during 
this meal, is also injurious, as it unnecessarily distends the 
stomach, and thus prevents its muscular contractions, at thi 



Cookery. 85 

rery time whwii it is necessary they should be brought into 
action, and preserved in their full vigor. To say the least of 
all these vuigar errors hi diet, they check the process of diges- 
tion, and paralyze the powers of the stomach. 

Supper. —As the powers of the body, and digestion among 
the rest, are diminished in their activity during sleep, it is an 
ansafe measure to load the stomach at bed-time with a quan- 
tity or various kinds of food. Do not eat meat for supper. 
Under no circumstance should food of any kind be taken for 
two or three hours before retiring to rest. 

Drinks. — In warm weather a much greater quantity of drink 
is demanded, than when the atmosphere is temperate or cold. 
This arises from the stimulating effects of heat upon the sys- 
tem ; but chiefly by the waste of the fluid portion of the blood, 
occasioned by the increased perspiration. For the same rea 
eons, active exercise or labor augments the thirst. Salted, 
high-seasoned, and all stimulating food increase the demand 
for drink, by stimulating the lining membrane of the mouth, 
throat, and digestive organs, and increasing the viscidity and 
exciting properties of the biood. Nature calls for water to 
take out the salt or other stimulating substances contained in 
the food, so that digestion may be more easily accom- 
plished. 

Persons in good health, generally, take a great portion of 
their drinks, especially at dinner, of the temperature of the 
atmosphere ; but in weaker stomachs, the drinks may be re- 
quired to be a little warmed, though it is seldom safe to take 
them habitually very hot / and far less is it proper to chill the 
energies of the stomach, by cold or iced drinks. The quantity 
of drink taken, is also of much consequence to good digestion ; 
a large volume of fluid will prevent the food from being pro- 
perly acted upon by the stomach ; and if there be too little, 
the mass will be dry and hard. Different kinds of food require 
different quantities of liquid : animal food requires more than 
vegetable ; roasted, more than boiled ; and baked meat, more 
still than roasted. To drink much before a meal, is unwise ; 
but to drink more or less, during a meal, according to the na- 
ture of the food, assists digestion.- 

Toast-water is perfectly wholesome, and agrees frequently 
with persons whose stomachs do not relish pure water. It has 
ft slightly nutritive quality, and may be allowed in all the fe- 
verish and other cases, where cooling drinks are proper. 

Whey affords a bland, easily assimilated nourishment 
increasing the secretions, and tending to produce a beneficial 
change in the fluids of the body. It contains a considerable 



86 Cookery. 

amount of sugar, wliicli renders it sufficiently nutritious. Afl 
a drink, whey is well adapted to allay thirst in hot weather. 

Buttermilk contains but little nutritious matter / but, ii 
warm weather, it forms an excellent cooling drink, and 
with bread, may constitute a considerable part of the diet of 
children. 

Tea. — The properties of tea seem to be those of an astrin- 
gent and narcotic ; but like some other narcotics, in smal 
quantity, its first effect is that of a very gentle stimulant, and 
certain kinds of it, when taken pretty strong, and near the 
usual time of going to rest, have the effect of keeping off sleep ; 
but when weak, and taken moderately, and tempered with 
cream and sugar, it acts merely as a grateful diluent, and 
produces a slight exhilaration. 

Tea and coffee, when used in moderation, are beneficial, by 
preventing the waste of the tissues of the body. Of course, 
where they disagree with the system, as we observe in some 
temperaments, they must be discontinued. 

The green and high-flavored teas are those which are the 
least wholesome. Tea should not be taken soon after dinner. 

The following rules, respecting the use of tea, will be found 
useful: — Carefully avoid the high-priced and high-flavored 
teas, more especially if green. Take with it, at all times, a 
good proportion of milk, and some sugar, as correctives to any 
possible noxious qualities present. Make the infusion proper- 
ly, with water, soft, and otherwise of a good quality, and in a 
boiling state. Take less tea in the morning than in the eve- 
ning. 

Coffee. — The infusion of coffee acts as a stimulant upon the 
Rtomach, the heart and the nervous system, increasing the cir- 
culation of the blood, augmenting the heat of the skin, and 
exhilarating the mind ; these, its immediate effects, are follow- 
ed, however, by an equal degree of depression in the function! 
of those several organs : the excitement and subsequent depres 
sion being in proportion always to the strength of the infusion, 
and the quantity drank. Coffee bears a strong analogy, in \Xx 
effects upon the system, to wine, ardent spirits, and opium ; 
from the latter, its effects, however, are very different in de- 
gree. Coffee, therefore, when drank very strong, or indulge© 
in to excess, is unquestionably injurious ; it seldom fails to 
disorder the stomach, impair its digestive powers, and in del 
ioate habits it often occasions watchfulness, palpitation of the 
heart, head-ache, and many of those complaints, vaguely de- 
nominated nervous. To the dyspeptic and sedentary especially 
it forms a very improper article of diet. When taken weak 



Cleanliness, . 87 

and with plenty of cream or milk and sugar, it may hcwever 
bt indulged in sparingly, by persons in health, and who lead 
active lives, without much inconvenience. CofTee should 
never be taken late in the evening, in consequence of its tei> 
dency to prevent s.eep, 

CLEANLINESS. 

Personal cleanliness consists in the careful removal of QYGfp 
impurity from the surface of the body, whether generated by 
itself, and attached to the clothing in immediate contact -fl-th 
ft, or contracted from the air and other matters with which 
the body is accidentally or constantly surrounded. Allowing 
impurities to accumulate upon the surface not only gives rise 
to a disgusting effluvia, by which the air the individual 
breathes is contaminated, but occasions various eruptive dis- 
eases of the skin, and the internal organs sympathize with it. 
Whatever suspends or impedes the functions of the surface, 
whether cold or filth, a derangement to a greater or less ex- 
tent of the internal organs invariably results. By the action 
of the numerous blood-vessels of the skin, there is removed 
from out the system, in the form of an insensible perspiration, 
an immense amount of matter, the retention of which would 
be productive of uncomfortable feelings or disease. 

The means of preserving the purity of the skin is frequent 
ablutions with water, with the addition occasionally of soap 
and frictions. The ablution of the body should be frequent 
and general, and not confined simply to the face, neck and 
hands. Washing the entire surface in water of a proper tempe- 
rature, and at short intervals, would sensibly increase the 
strength, health, and pleasurable feelings of all, whatever may be 
their sex, age, or condition in life. Frequent change of clothing 
is equally necessary. Domestic cleanliness is of scarcely lesa 
importance to the preservation of health than that of the per- 
son and clothing. Fiom every apartment of our dwellings, as 
well as from the yards, cellars, vaults, and outhouses attached 
to them, should every species of filth, every thing which by its 
decomposition is liable to contaminate the air, be immediately 
removed. 

We should prevent all accumulations of filth and stagnant 
arater in the streets, courts, and alleys of towns, drain marshes, 
and keep sinks, and privies well cleaned out, and frequently, 
in warm weather more especially, dissolve one pound of sul 
phate of iron, (common green vitriol or copperas,) in a pail of 
tot water, and throw some down the sinks, privies, &c— 



88 Cleanliness, 

Never leave slops, or any thing offensive, in sleeping apart 
ments, but let them be removed at once, more especially in 
cases of sickness. Many families have been prostrated with 
various forms of fevers, dysentery, or other diseases, by the 
slops from the kitchen being thrown into the yard, and there 
decomposing, and generating poisonous gases. 

Unless their debility be very great, and unless it oe 
productive of much pain and suffering to move them, the bed 
and body linen of the sick should be kept very clean, and fre- 
quently changed ; their apartment should be cleaned and wel 1 
aired, and all offensive discharges should be very carefully and 
speedily removed. 

Soap. — In addition to the perspiration which is thrown out 
by the skin, a portion of which always remains upon the sur- 
face, the latter is constantly lubricated by an oily fluid. Thia 
oily exudation greases the linen when it is worn for too iong a 
time — catches the dust floating in the air, and causes it to ad- 
here to the skin, and likewise retains in contact with our 
bodies, a portion of the dead matter, which it is the office of 
the skin to discharge from the system. The removal of this 
deposit, which is constantly accumulating, is absolutely neces 
sary, as well for personal comfort as for the preservation oi 
health. It cannot be effectually removed without the occa- 
sional use of soap, with which it combines without difficulty. 
Washing all over, with soap and water, occasionally, is very 
necessary. 

Mechanics, and they who, from any cause, are peculiarly 
liable to have deposited upon their skin, dust, dirt, or any 
foreign matters, should wash with soap and water often, and 
also rub afterwards well with a rough dry towel, as veil for 
the preservation of the skin as of their health genera'. '/. 

If you can only get a bowl of cold water, some /,oo6 soap 
and a rough towel, yoa can have all the advances to be 
derived from the most fashionable bath-tub — onlj being care- 
ful to avoid getting cold, by thorough rubbing of the surface 
with a dry towel, after the washing all over in soap and water. 

The ordinary brown and yellow kinds of soap are altogether 
unfitted for cleansing the skin, as they irritate it, and when 
frequently used, most generally cause it to become rough, 
chapped, or covered with painful and unsightly pimples. Most 
if not all, of the colored and variegated soaps, prepared express- 
ly for the toilet, are equally objectionable. Pure white soap 
ought, therefore, to be invariably used in ablutions of tk-3 fact 
and hands, or of the surface generally. 



Step. 89 

SLEEP. 

It is highly important that every body should understand 
that sound, refreshing sleep is of the utmost consequence to the 
health of the body, and the vigor of the mind. 

Among the marks and symptoms of long life, that of being 
naturally a regular and sound sleeper, is considered to be one 
of the surest indications. Great watchfulness, by accelerating 
the consumption of the fluids and solids, abridges life, and a 
proper quantity of repose must tend to its prolongation. 

Quantity of Sleep. — What number of hours are necessary 
to be passed in sleep, is a question that has occasioned much 
discussion. The opinion generally entertained by the ablest 
physicians, is, that from seven to eight hours, in the four-and- 
twenty, constitute, generally speaking, the proper time, and 
that this period should scarcely ever be exceeded by adults, 
in the enjoyment of health, though the delicate require more 
than the vigorous, women more than men, and very young 
children more than either; but it is worthy of particular re- 
mark, that the sick and weakly seldom require more than 
eight hours, or at the most, nine hours, and will rarely, if ever, 
fail to be injured by a longer indulgence. 

Proper time for Sleep.— Nature certainly intended exer- 
cise for the day, and rest for the night. Working at night 
and sleeping in the day time will, sooner or later, destroy the 
best constitution. Another point to be considered is, that by 
the custom of sitting up late at night, the eyes suffer severely, 
day-light being much more favorable to those delicate organs, 
than any artificial light whatsoever. 

The plan of going to bed early, and rising betimes, has been 
called the golden rule for the preservation of health and the 
attainment of long life, and it is a maxim sanctioned by va- 
rious proverbial expressions. 

Indulging in sleep during the day-time, and more especially 
after dinner, is always productive of more or less injury to 
health, while it is never found to produce even that temporary 
feeling of refreshment which results from the same amount of 
repose taken at night. 

Best Means of Promoting Sleep. — The principa. 3ircun> 
•tances to be attended to, in order to procure refreshing sleep* 
are, the nature and quantity of our food and exercise ; the six* 
and ventilation of the bed-chamber ; the quality of the bed and 
of its coverings ; and the state of the mind. 

It is certain that a full stomach almost invariably occasion! 
restless nights, and it is, therefore, an important rule to make 
a very light supper. 



90 Steep. 

With some persons, the most effectual methods of procuring 
sleep will fail, unless exercise be resorted to in the open air. 
Pure air has of itself an exhilarating and soothing effect on 
the mind, conducive to sound repose. It is an excellent plan : 
when the exercise of the day has been limited, to walk up and 
down a large room or passage for half an hour, or more, before 
going to bed, and the use of the dumb-bells for a part of tb« 
time will augment its good effects. 

If, notwithstanding an adherence to the preceding ^ules, 
sleep is still found to be unsound and unrefreshing, a brisk 
use of the flesh-brush, before going to bed, or rising from the 
bed, and freely ventilating it, will often produce a very favor- 
able change. 

Another excellent practice, in case you have gone to bed, 
and cannot sleep, is to rise, shake the bed well, draw the up- 
per clothes down to the feet, and walk about the room, 
warmly clad, till both you and the bed are aired. Opiates 
and sleeping draughts should never be resorted to, to procure 
rest — once resorted to, their habitual use will become neces- 
sary, as sleep will not occur without their aid ; while by their 
prejudicial influence upon the stomach and other organs, their 
employment will never fail, gradually, to undermine the health 
of the system. 

The following miscellaneous rules respecting sleep deserve 
to be recorded in this place : Many real or imaginary inva- 
lids lie long in bed in the morning, to make up for a deficiency 
of sleep in the night time ; but this ought not to be permitted, 
for the body must necessarily be enervated by long continu- 
ance in a hot and foul air. By rising early, and going to bed 
in due time, their sleep will become sound and refreshing, 
which otherwise they cannot expect to be the case. It is an 
indispensable rule, that fat people should avoid soft beds, and 
should sleep little and rise early, this being the only chance 
they have of keeping their bulk within due bounds. Such 

Eersons as are subject to cold feet, ought to have their lega 
etter covered than the rest of the body, when they are in 
bed. We should never suffer ourselves to doze, or fall asleep, 
before we go to bed. Heading in bed at night is a most per- 
nicious custom ; it strains the eyes, prevents sleep, and injure* 
the health. Remember, sleep is sound, sweet, and refreshing 
according as the mind is free from uneasiness, and the diges* 
tive organs are easy, quiet and clear. 

Beds. — The use of feather beds is very common ir this 
country, especially in the rural districts, yet there can be no 
doubt that they are highly injurious to health To the invalid, 



Sleep. 91 

and to ;young persons who are disposed to distorticn of the 
spine and shoulder, they are particularly hurtful. Such as 
consider them a necessary luxury in the winter, should inva- 
riably exchange them for a mattress in the spring and summer. 
The injury resulting from feather beds is occasioned, princi- 
pally, by their accumulating too much heat about the body, 
and in this manner causing a profuse anxi debilitating per 
spiration, and predisposing the system to the influence of slight 
changes of temperature. By yielding unequally to the pressure 
of the body, the latter is thrown into a distorted position, 
which being resumed regularly almost every night, is liable to 
cause in the young and weakly a permanent deformity. Corn 
husk or shuck mattresses are superior to every other kind of 
bed, and it is highly desirable they should be generally adopt- 
ed. By those whose means will not permit the purchase of 
hair mattressess, those of moss or straw will be found an 
excellent substitute. Feather beds are more injurious to the 
health of children, than even of adults, and especially if they 
are weakly. 

In very cold climates feather beds are often necessary, and 
the aged may often require them, in order to preserve or 
increase their heat, which is sometimes inconsiderable, and if 
lessened would prevent their sleeping. 

Young people and invalids, in particular, ought to avoid 
many, and heavy, bed-clothes. The use of curtains to the bed 
should be avoided : they are injurious, by preventing the 
proper circulation of the air breathed by those who occupy the 
bed, and by accumulating dust, cause it to be inhaled into and 
imtate the lungs. 

Beds and bed clothes are apt to become damp for want of 
proper airing when not constantly used. Colds, rheumatisms, 
and even more fatal complaints may be caused by occupying 
a damp bed. Beds, instead of being made up soon after the 
persons-rise from them, should be turned down, or their cov- 
erings thrown separately over the backs of chairs, and thus ex- 
posed to the fresh air from the open windows during the day. 

Bed-Rooms. — A bed-room ought not to be situated on the 
ground floor: an elevated apartment is particularly recom- 
mended. It should be airy, large, and lofty. The more airy 
a bed -room is, the better ; and it will be still better if it be 
also exposed to the influence of the sun. A bed-room ought 
to be well ventilated in the day time, as it is principally oc- 
cupied in the night, when all the doors and windows are shut. 
The windows should be kept open as much as the season will 
admit of, during the day. 



92 The Passions. 

Keeping open the windows of bed-rooms during the night 
ought never, however, to be attempted, but with the greatest 
caution, except a small space for ventilation, by lowering the 
„op sash, when practicable, or raising the lower one slightly. 

Do not sleep in a very warm room. 

Unless there is an apprehension of damp, a bed-room should 
rarely have a fire in it. They who live in hot countries ought 
to be very particular regarding the place they sleep in. Th« 
apartment should be roomy, dark, shaded from the rays of the 
sun and moon ; temperate as to heat and cold, and rather 
inclined to coolness than heat ; while a free admission of air ia 
allowed during the day time, the windows should be carefully 
closed as soon as the night sets in. 

Dreaming. — As a general rule, dreaming may be prevented 
by whatever causes perfect and uninterrupted sleep ; such as 
sufficient exercise during the day, temperance in eating and 
drinking, a cheerful and contented mind, and the avoidance of 
late or heavy supper, or of strong tea or coffee during tho 
evening. Many of the sudden deaths which take place during 
the night, in persons apparently in the full enjoyment of health, 
are to be attributed to night-mare. 

The night-mare is a certain uneasy feeling during sleep, ao 
of great anxiety and difficulty of breathing, and of strong but 
ineffectual efforts to shake on some incumbent pressure, or to 
relieve one's-self from great inconvenience. It commonly 
arises from an imperfect and unhealthy digestion, from heavy 
suppers, and from a constrained uneasy posture of the bodv . 
Such persons as are subject to the night-mare should take no 
food whatever in the evening, should keep the bowels open, 
and should sleep upon a mattress with the head and shoulders 
raised. 

THE PASSIONS. 

Joy. — Instances are not wanting, in which this passion 
when unexpectedly excited and violent, has produced disease, 
or even immediate death ; but when moderate, and existing 
only in the form of cheerfulness, it has a beneficial effect in 
preserving health, as well as in the cure of disease. 

Hope. — Of all the passions, hope is the mildest ; and, though 
it operates without any visible commotion of the mind or of 
the body, it has a most powerful influence on the health of the 
one, and the serenity of the other: it contributes, indeed, so 
much to the welfare of both, that if it were extinguished, we 
could neither enjoy any pleasure in this life, nor any prospect 
of happiness in the life to come ; but by the beneficent will of 
Proviaence, it is the last of the passions that forsakes us. 



The Passions. 93 

Love ip one of the strongest and most absorbing passions 
with, which the mind is affected, and has at its commeneemen 
when happy, and properly guided by reason, a favorable influ 
ence on all the functions of the body; but being often in ita 
progress attended with other passions, such as fear and jeal- 
ousy, it is liable to become the source of infinite disquietude. 
~No passion undermines the constitution so insidiously, aa 
violent and unreasonable or misplaced love. While the whole 
poul is occupied with the thoughts of a pleasing attachment 
both the mind and the body become languid from the contin- 
uance of vehement desire ; and should there arise any prospect, 
real or imaginary, of being frustrated in its gratification, the 
person is agitated with all the horrors and pernicious effects 
of despair. Love, when violent and unsuccessful, frequently 
produces a wasting of the body, terminating sooner or later in 
death. 

Fear. — When intense or habitually indulged in, it destroys 
the energies of both mind and body, retards the motion of the 
blood, obstructs digestion, and prevents the proper nutrition 
of the body. Violent terror has been known, in an instant, to 
tarn the hair perfectly white, and in other instances, to produce 
loss of mind, or even instantaneous death. By weakening the 
euergies of the system, this passion disposes greatly to disease 
during the prevalence of epidemics. 

Grief. — There is no passion more injurious to health than 
grief when it sinks deep into the mind. By enfeebling the 
whole nervous system, it depresses the motion of the heart, and 
retards the circulation of the blood ; it disorders the stomach 
and bowels, and ultimately every other organ of the body, 
producing indigestion, consumption, and other chronic diseases. 
Grief long continued, often gives a shock to the constitution 
that nothing can retrieve. Grief, like fear, predisposes to an 
attack of epidemical diseases. 

Anger is a passion suddenly excited, and which often no 
less suddenly subsides. The nerves are unduly excited ; the 
pulsation of the heart and arteries, and with them the motion 
of the blood, are sometimes so much increased, as to occasion 
the bursting of some of the minute vessels of the brain or lungs* 
The stomach, liver and bowels, are often violently affected by 
intense anger — digestion is always disordered, a violent colie 
is sometimes produced, and very often all the symptoms of 
jaundice. Thus it is often the immediate agent in the production 
of fevers, inflammations, spitting of blood, apoplexy, and other 
acute disorders. An essential means for their subjection, is a 
regular, active mode of life, a mild and moderate diet, and 



94 Care of the Hair. 

the abandonment of all intense excitements and stimulating 
drinks. 

Anxiety of Mind, when constantly indulged in, destroys 
the digestive powers of the stomach, impairs the functions ot 
the lungs, disturbs the regular circulation of the blood, and 
mpedes the nutrition of the system. It is a fruitful source of 
chronic affections of the stomach, liver, heart, lungs and brain, 
Even the anxiety induced, in a sensitive mind, by the ill-hu 
mor, caprice and unkind treatment of others, is deeply felt, a^d 
proves highly injurious to health. 

CARE OF THE HAIR. 

"Whatever has a tendency to impede the passage of the fluids 
by which the hair is nourished, from the root along the cavity 
which exists in the centre of each hair, must necessarily pre- 
vent its proper growth — render it thin, and deprive it of ita 
soft and glossy appearance. There can be little doubt that 
this is the effect, to a certain extent, of the practice of twisting 
the hair from its natural position, and of plaiting or firmly 
braiding it, pursued in obedience to the dictates of fashion, by 
most females. 

"Whenever the hair becomes thin and irregular, or its beauty 
is otherwise impaired, nothing is better calculated to restore 
its proper growth than cutting it short. Frequently cutting 
the hair also prevents it from splitting at the ends. 

In children, keeping the hair short is a circumstance of no 
little importance. Nothing is more common than to see a 
luxuriant head of hair accompanied in children by paleness of 
complexion, weak eyes, and frequent complaints of headache. 

The hair of children should be cut short until they are eight 
or nine years old. There is good reason for believing, that 
children who have a great quantity of hair, are those most 
liable to eruptions, as scald head, &c. : it is at least certain, 
that in them eruptions are very difficult to remove. 

Mothers, whose vanity may be alarmed lest repeated cutting 
the hair for so many years should make it coarse, may be as 
gured they have no cause for this apprehension. 

When there is any tendency to sores or eruptions on the 
head of children, fine combs are very apt to promote them 
The seldomer a fine comb is applied to the head of an infant 
the better. However, the head should be well washed witl 
a good lather of soap and cold water (once a week), afterward 
washing the soap out with clean water, rubbing with a drj 
towel, and then giving the hair a good brushing. "Washing 
the hair in cold water every day, is a great advantage to it 



Preservation of the Sight — Care oj the Bowels. 95 

PRESERVATION OF THE SIGHT. 

The following are the general rules for preserving the sight 
Uiimpaired for the longest possible period. 

All sudden changes from darkness to light, and the contrary, 
hould be avoided as much as possible. 

Avoid looking attentively at minute objects, either at dawn 
ar twilight, and in dark places. 

Avoid sitting near a dazzling or intense light, as of a lain^ 
on candle, and facing a hot fire. 

Avoid reading or sewing much by an imperfect light, as 
well as by artificial lights of any kind. 

Avoid all dazzling and glaring sunshine, especially when it 
is reflected from snow, white sand, or other light colored 
bodies. 

Avoid rubbing or fretting the eyes in any manner, and wip- 
ing them with cotton handkerchiefs. 

Avoid all spirituous and heating liquors, rich and highly 
seasoned food, and every species of intemperance, all of which 
invariably injure the eyes and impair their sight 

CARE OF THE BOWELS. 

An evacuation once in the twenty-four hours is the best 
standard of frequency — this, in general, takes place whenever 
the digestive organs are in a state of health. 

Confinement to a diet composed chiefly of dry animal food, 
or of food highly seasoned — the use of fresh bread, and of warm 
rolls and cakes, very generally induce a costive state of the 
bowels. Costiveness is very common also in persons who use 
little exercise, or who pass the greater part of the day within 
doors in occupations of a sedentary character — females are 
much more subject to it than males. Lying in bed to a late 
hour in the morning is unfavorable to a regular condition of 
the bowels. 

Early risers, who pass several hours of the morning walking 
abroad in the open air, seldom complain of any want of regu- 
larity in their stools. 

The daily use of wine, especially the red or astringent 
varieties, retards very materially the natural discharges from 
the bowels. The same effect takes place in persons who past 
the greater part of their time in company, and who from a 
false delicacy resist the calls of nature. 

In costiveness, besides early r:'sing, daily exercise of the bod) 
in the open air, and abstinence from wine and ardent spirits, 
the (Let should be composed principally of vegetable food 
Plain soups, especially of veal and mutton, with the addition 



96 Fed. 

of the ordinary vegetables, well boiled a^d not too highly sea- 
Boned, will be found a very excellent diet for those inclined to 
costiveness. Fresh fruits, perfectly ripe, or fruit cooked, with 
or without the addition of sugar or molasses, are gently lax- 
ative. Spinach, when in season, and properly boiled, is also a 
very pleasant and wholesome vegetable for persons of costive 
habits. Bran bread, or wheaten bread with an admixture of 
tye or Indian meal, is better suited to the habitually costive 
than bread composed entirely of line wheat flour. For drink, 
those troubled with costiveness should make use of water, 
either alone, or with the addition of a small quantity of sugar 
or molasses. A very pleasant drink is made by dissolving 
currant jelly in water, or by pouring boiling water upon sliced 
apples or peaches, and allowing it to stand until cold. This 
acts gently upon the bowels. Buttermilk, or sweet whey, may 
likewise be occasionally drank with advantage by those whose 
discharges are defective : all ardent spirits and wines, especi- 
ally those of an astringent nature, should be carefully avoided. 
The method recommended by the celebrated Locke, for pro- 
curing a regular discharge from the bowels, is founded on 
correct principles, and should not be neglected ; it is, " to 
solicit nature, by going regularly to stool every morning, 
whether one has a call or not." 

To remove costiveness, individuals should be extremely 
cautious in resorting to purgatives, or those medicines, under 
whatever name they may be sold, which have the effect of 
inducing evacuations from the bowels. The frequent use of 
these articles, however mild their operation may appear to be, 
tends to disturb the stomach and bowels ; and consequently to 
vitiate or retard digestion. 

THE FEET. 

The feet are extremely subject to the impression of cold, and 
when chilled, in consequence of the close sympathy between 
them-nnd other parts of the body, disease is apt to be occa- 
sioned in some one of the internal organs. They should be 
protected always from cold and damp, but when accidentally 
wet, the shoes and stockings should be immediately changed, 
and the feet bathed in cold water and rubbed perfectly dry 
with a coarse cloth. Tight and misshapen shoes are injurious, 
by preventing the circulation of the blood, causing coldness of 
the feet, and producing corns. The feet are generally much 
neglected. They should be washed at least once every day, 
and rubbed well afterwards with a rough towel, or flesh brush. 
Thin shoes are killing thousands of females every year— awaj 



Physical Education and Diseases of Children, 97 

with then: at once. Females should wear thick, warm 
shoes, at all times during cold or damp weather. 

PHYSICAL EDUCATION AND DISEASE*. 
OF CHILDREN. 

General Symptoms of Disease. — It is often difficult in very 
young children to determine the disease with which the littlo 
sufferer is afflicted, — for as we can obtain no information from 
the patient relative to his feelings or the history of his maiady, 
we are obliged to form an opinion from external symptoms 
alone. The symptoms of disease are nearly the same in child- 
hood as in maturer age. The sleep, motions, breathing, 
evacuations, pulse, appetite and mental manifestations, all 
afford important appearances. The countena/nce is in most 
cases an important index of disease ; when the expression is 
calm or lighted up by a smile, it indicates a state of ease and 
a regular performance of all the functions : frowning or con- 
traction of the features, pale, red, or blue tint of the face, 
rolling up of the eyes, swelling of the upper lip, twitching of 
the muscles, dilatation or spreading of the nostrils, are all evi- 
dence of approaching or confirmed disease. The sleep, in a 
healthy infant is quiet and profound, and indicates a state of 
ease and comfort ; but if there is sleeplessness, sudden starting 
during sleep, slight spasms, screaming, fright, or deep and 
Laborious sleep, there is some disturbance of the brain or stom- 
ach and bowels. 

Crying is the natural language of infancy, and the only 
means by which very young infants express their wants and 
Bufferings. Healthy infants cry but seldom, and then only to 
express some slight uneasiness or vexation : but violent parox- 
ysms of crying, (unless from anger,) plaintive moaning, short 
and suppressed, a hoarse or shrill cry, indicate disease. The 
breathing in health is full, easy and regular, — but it sometimes 
becomes slow, irregular, difficult, short, laboring, rattling, 
shrill "crowing" intermittent, or attended with 30ugh, 
sneezing or hiccup in sickness. 

The tongue and mouth sometimes show important charac- 
teristics of disease : paleness or redness, brown or white fur, 
dryness, swelling, trembling, ulcers or cracks in the tongue ar« 
Signs of disease. Unusual redness of the gums and throat, 
increased or diminished secretion of saliva, (spittle,) bitter taste 
or brown scum on the teeth, also point to diseased action in 
some part of the system. The skin, in health is soft, slightly 
moist and warm, and has a slight crimson tint of the blood 



98 Management of Children 

but when it becomes harsh, dry, hot, shriveled, pale, coll. 
clammy, blue, red, or yellow, some disease exists. A cold 
profuse perspiration shows debility or other disease : many of 
the eruptions of the skin indicate disease of the digestive 
organs ; itching and tingling of the skin are signs of irritation 
from worms or other causes. The breath, if rancid, sour o» 
unpleasant, is the result of fever, indigestion or ulceration* 
The evacuations from the stomach, bowels and bladder, are in 
nost cases peculiarly characteristic, and are important symp- 
toms : frequent vomiting of curdlike, green, bilious, sour, 
bloody or black matter, is evidence of disease of the brain, 
stomach, liver, kidneys or bowels. When the evacuations 
from the bowels are frequent, slimy, bloody, green, black, 
gray, or profuse and destitute of odor, or mixed with flakes of 
mucus or pieces of undigested food, or when great costivenesa 
is present, there is disorder of the digestive organs. If the 
urine is white, red, of unpleasant odor, or deposits a brown or 
gray sediment, (or settlings,) is scanty, profuse, or passed with 
difficulty, there is morbid action of the kidneys or some other 
part. The development of the hones is often indicative of some 
disease : narrowness of the chest and very prominent breast 
bone, great length of body and limbs, large joints, curvatu/e 
of the bones of the legs, brittleness of the bones, large head, 
weak joints, open seams, (sutures,) in the skull, and crooked 
back, all indicate a rickety, scrofulous or debilitated state of 
the system. 

The symptoms above enumerated are sufficient to enabla 
the common observer to detect the existence of disease. 

MANAGEMENT OF CHILDREN. 

Am. — A constant supply of pure air is indispensable to the 
health of every human being, from the first moment of exist- 
ence to the end of life. This is even more necessary for 
infants than for adults, on account of the rapidity of the cir- 
culation and breathing, and the weak and irritable state of 
the nervous system. Children confined in badly aired rooma 
becDme pale, feeble, irritable and finally consumptive. The 
air in their sleeping rooms should not be too warm, as thig 
causes oppressive breathing, too great perspiration, feverish- 
ness and oppression of the head. Neither should it be toe 
cold, for this checks the insensible perspiration which is con 
stantly going on during health. Yery cold air also closes tha 
pores on the mucus membrane of the nose, throat, windpipe 
and lungs, and inflammation and fever ensue. Beware how 
vou attempt to " harden" your children by putting them to 



Management of Children 99 

sleep in a very cold room ; croup and inflammation of the 
tangs are often thus produced. 

Children should be carried or permitted to go into the open 
air often, and always with their faces bare unless the weather 
be inclement. The face should never be muffled or covered 
during sleep. The temperature of the nursery and sleeping 
room should never exceed 65° or 70°; older persons shouM 
QOt judge of this by their own feelings, as a degree of coi<3 
which to them would be comfortable, might be injurious or 
dangerous to an infant. Keep a thermometer, and go by 
that. 

Bathing. — The infant may be bathed every morning during 
the first two or three months, in tepid water, after which the 
bath may be nearly or quite cold. The idea that the cold 
bath is best for all children, is erroneous, — it is equally wrong 
to suppose none but the warm bath is safe and beneficial. 
Some infants have not sufficient vitality and strength to bring 
about reaction so as to recover from the shock and regain their 
natural warmth, but become weak, chilly and sick, by the use 
of the cold bath. Those of a robust and full habit of body on 
the contrary, by the use of the warm bath are affected by 
congestions of the stomach, lungs and brain, and suffer from 
indigestion, headache and convulsions. For pale, feeble and 
irritable children, the tepid bath is usually the best adapted : 
the temperature of this bath is from 80° to 90°. For those 
of active circulation, good digestive powers and robust health, 
the temperature may be 60°, — constituting the cold bath. 
Immediately after bathing, the surface of the body and limbs 
should be well dried and rubbed with a linen napkin, and the 
child dressed and allowed to exercise. The cold bath should 
not be used during profuse perspiration, during a chill, nor 
sooner than three hours after eating. If there is roughness or 
smarting <~>f the skin after bathing, it may be rubbed with a 
very little sweet oil, or a little starch powder. Children are 
iasily bathed by a cloth, or soft sponge and basin of water. 

In bathing infants, the head should always be wet, but not 
washed with soap, as this fades the hair. Too frequent use 
of the cold bath produces eruptions on the skin, debility and 
disease of the heart. 

Clothing. — Every part of the person should be covered ex 
eept the head, face and hands. Bare arms and low-neck 
dresses may be very pretty to look at, but it is a dangerou* 
practice ; many times little children are thus sacrificed to the 
whims of folly and fashion. 

The habit of putting caps on infants is useless and injurious," 



100 Management of Children. 

fiie habit of allowing them to go barefoot is vulgar and cruel,' 
*be practice of swathing or bandaging the bodies of children, 
ta totally useless, and very pernicious to their health and com- 
fort. Soft, white woolen flannel should be worn next to the 
&kin daring winter and the colder part of spring and autumn. 
When the flannel is laid off, cotton may be substituted by 
degrees : this may be done also, at any time when wooleD 

Jmears to be too irritating, as sometimes happens. The night 
othes should be light and perfectly loose : the whole dresg 
should be fastened by means of buttons, hooks and eyes and 
tapes, to avoid wounds from pins. 

Sleep.- — The sleep should be voluntary, and not forced or 
induced by medicines or rocking ; neither should it be dis- 
turbed for the purpose of washing, nursing or dressing. Young 
children require a soft, warm couch in winter, but during 
warm weather they should lie upon beds filled with straw, 
cotton, curled hair, moss or corn-husks. The pillow should be 
of the same material as the bed, to prevent the head becoming 
too much heated, and avoid taking cold, earache, catarrh and 
snuffles. During the first three or four months it is better to 
allow the child to sleep with, the mother, — after which it may 
sleep alone, (if the weather is warm,) in a cradle, cot or couch. 
The habit of rocking infants, if frequent or long continued, is 
injurious, — but if gentle and only occasionally during waking 
hours, it is both harmless and pleasing to the child. The bed 
or cradle should be high and without curtains: that old 
fashioned contrivance called a " trundle bed, " is a vile relic 
of barbarism, and deserves to be totally banished from civil- 
ized society. The 'position should be occasionally changed 
during sleep : this prevents too much pressure on any part, 
accumulation of heat, deformity of the head, and fatigue. 
The room in which the child sleeps should be partially dark- 
ened : during waking, it requires the stimulus of a mellow 
light, this conduces both to its health and cheerfulness. The 
eves, however, should not be long exposed to the intense glar* 
"ng light of the sun, fire or lamp. 

All perfumery, flowers, medicines or food, or anythihg 
exhaling a strong odor, should be excluded from sleeping 
apartments. Children ought never to sleep with old or siot 
persons : neither should they be fondled or kissed oy aid, di» 
eased or strange persons, for fear of incurring some disease 
Young children should be protected against loud noises 
strong odors, and sudden frights. Children of more advance* 
*ge should retire early, and rise early in the morning. 

Exercise.— During the first few months of infancy* V>ut 






Management of Children, 101 

little exercise is required, — nor does the organization admit 
©f more than a small amount of passive and gentle movement. 
The infant may be carried about in the arms within doors, — 
or when the weather is pleasant it may be carried in the 
arms or frawn in a wagon, laying on a pillow, in the open 
air, a few minutes at a time, several times daily. All rough 
tossing, jolting and dandling are injurious. For the first two 
months, the infant cannot bo placed in the erect posture 
without the risk of deformity. 

When the infant indicates some desire to sit alone and 
move about, he may be allowed to sit, lie or roll about on the 
floor with the utmost freedom. When riding, the position 
should be often changed, and nursing should be done equally 
upon the right and left side, to avoid deformity of the head 
or spine. 

It is better that the child should not attempt to stand or 
walk before the ninth or tenth month: it should rather be 
encouraged to creep until it acquires sufficient strength and 
firmness to walk voluntarily. Children should not be con- 
fined to little chairs, " baby jumpers," or any apparatus for 
restraint / although it may relieve the mother or gratify the 
laziness of the nurse, — it is still unnatural and injurious to 
the delicate growing system of the child. After the age of 
two years, girls as well as boys should be permitted to roam 
free and unconfined over the wide field of nature, and inhale 
the " pure breath of heaven." The first six or eight years of 
childhood should be passed in various kinds of exercise and 
amusements. Confinement in school rooms or shops, or at 
desks, or to any laborious occupation previous to that age, is 
always injurious and unkind. Nothing is gained and much 
is lost by sending a child to school too young. No child 
under six years should be sent to school, and even then only a 
few hours at a time. 

Children should be indulged in pursuing little mechanical 
operations, and in learning to build and construct whatever 
their tastes may incline them to : they should be taught to 
admire the beauties of nature, rather than be supplied with 
the various little toys and expensive contrivances of art. 
They should be permitted to take short rambles for the pur- 
pose of collecting flowers, insects, minerals or fruits, or to 
observe the habits of animals and birds, and enjoy the pro- 
•pect of natural scenery. 

Duinks. — Infants feel the sensation of thirst, as early aa 
that of hunger, and are highly gratified and benefitted by a 
small quantity of cold water several times daily. 



102 Nourishment of Infants. 

.Restlessness and crying are often caused by thirst, but mis 
taken for colic or hunger, and the infant is dosed with cordialt 
or opiates, or forced to take the breast, which only increases 
its distress, perhaps surfeits the stomach and causes nausea 
and vomiting. This leads to the apprehension *hat he is sick, 
and dose succeeds dose, till disease is often produced, — when 
a spoonfull of cold water would have removed all unpleasant 
sensations. Many people think it is a " healthy sign " for a 
child to throw up its milk, when the whole trouble is that 
the child has too much milk and too little water / ( Very coldy 
as well as very hot drinks should be avoided ) 

Diet. — As a general rule the mother's milk should be the 
only food for the first nine or ten months ; no solid food 
should be allowed until a sufficient number of teeth are 
developed, to enable the child to chew. 

When it becomes necessary to increase the amount of food 
derived from the breast, — or to " bring up the child by hand," 
cows' milk is the best substitute : it should be mixed with an 
equal quantity of warm water and a little loaf sugar added. 
All preparations of gruel, panada, broth, soup or solid food, 
are unfit for the diet of an infant. Animal food is too strong 
and stimulating for infants before the first set of teeth are 
complete. After teething is completed, a more solid and 
nutritious diet may be allowed. 

Food. — Care is requisite that too much of one kind of food 
be not taken, — but rather a due proportion of several kinds : 
the food should not be taken too fast or swallowed without 
being well chewed. Sugar and other sweet substances are 
not injurious when taken in due quantity and with other arti- 
cles of diet f all sweet and ripe fruits, when freed from the 
seeds, stones and skins, are wholesome and nutritious in small 
quantities. Sour or green fruits are decidedly pernicious, — 
cherries of most kinds, and also some kinds of grapes, are 
peculiarly unwholesome : ripe fruits, either dried or recent, 
when cooked or preserved and made palatable with sugar, are 
not objectionable for children. 

NOURISHMENT OF INFANTS. 

The foundation of incurable chronic diseases, and of con- 
stitutional debility in after-life, is often laid within the first 
month, or even first few days, after birth, by improper man- 
agement ; and a great amount of the suffering and mortality 
which occurs during^ infancy must be ascribed to the same 
prevailing source. The custom of feeding children with inap- 
propriate articles of food, very soon after birth, is wrong, No 



Nourishment of Infanta. 103 

•ooner is the infant washed and dressed, than tne nurse is 
ready with her spoon and cup of gruel, pulverized crackers 
dissolved in water, or some such preparation, to fill its stomach 
to the utmost of its capacity ; and this process of stuffing is 
continued with a ruinous degree of diligence and perseverance. 
The digestive organs of the new-born babe are thus often 
seriously injured during the first twenty-four hours. Nature 
herself seems to point out the impropriety of this practice. 
She withholds the nourishment which she provides (the milk) 
until many hours after birth. I do not mean to inculcate that 
nourishment is to be entirely withheld from the infant until 
the milk is secreted under all circumstances / but I am per- 
suaded that, with -healthy infants, several hours, at least, 
should be suffered to pass immediately after birth before any 
food is introduced into its stomach, and not, under any circum 
stances, give food to the child until it has first been put to the 
mother's breast several times, to see if the milk will not be 
excited to flow. In nine cases out of ten, perhaps, the griping, 
flatulency, diarrhoea, and colic, which so frequently harass 
infants, during the first half year after birth, are the results of 
indigestion, brought on by errors in diet. To relieve the 
colic, griping, flatulency, diarrhoea, &c, which ensue, recourse 
is had to cat-mint tea, aniseed tea, Godfrey's cordial, pare- 
goric, or some other palliative or nostrum, and thus an addi- 
tional cause of indigestion is brought into operation. The 
screams and restlessness of the infant occasioned by the 
griping and colic, are frequently regarded as manifestations of 
hunger. To appease this supposed craving, the stomach is 
almost constantly kept in a state of distension with food ; and 
thus the helpless babe has no chance of escaping from the tor- 
ments and ruinous consequences of its unfortunate situation. 
Great distress and suffering are sometimes witnessed during 
the early period of infancy from indigestion, and consequent 
irritation of the stomach and bowels, even where the child is 
wholly nourished by the breast. For when, during the timt 
which intervenes between the secretion of milk and the birth 
of the child, crude articles of nourishment are introduced into 
the infant's stomach, the digestive powers are often at once so 
deranged and impaired, that even the wholesome and conge- 
uial fluid furnished by the mother will not be easily digested 
and acidity, flatulency, and colic, will continue to harass th# 
child until the digestive powers gradually acquire a greater 
degree of vigor. 

Let the child's stomach be once or twice filled during the 
fwst twenty-four hours with gruel, or any of the ordinary 



104: Nourishment of Infants. 

preparations employed by nurses for this purpose, and tho 
chances will probably be as ten to one that sourness of the 
stomach, vomiting, colic, griping, &c, will supervene. There 
is no period throughout the whole course of life in which the 
observance of caution, in relation to the food, is of greater 
moment than in the comparatively short interval which passei 
between the birth of the infant and the secretion of its natt* 
ral aliment (milk). Do not be in too great haste to give pur 
gative medicine to a child, soon after it is born, to open its 
bowels. Active purgatives are sometimes given for this pur 
pose ; and there is much reason for believing that the infant's 
digestive organs are often injured in this manner. 

The very best thing to stimulate a secretion of milk is apply- 
ing the child to the breast, for a few minutes at a time, (com- 
mencing as soon as the mother is comfortably settled in bed,) 
every half an hour or so. If the child is hungry, his efforts will 
be the more vigorous to procure nourishment. A mixture of 
two parts of fresh cow's milk and one part of warm water, 
approaches nearer to the nature of human milk than anything 
else that can be conveniently procured. Of this a few tea- 
spoonfuls may be given la cases where the secretion nas been 
long delayed, carefully avoiding overcharging the stomach 
until the mother's breasts are ready to yield their more con 
genial nutriment. In order to excite the early secretion of 
milk, it will be proper to let the child draw the breasts, for a 
few minutes, soon after the mother is comfortably h'xed in bed, 
provided her health and strength will admit of it. After the 
secretion of milk is once fully established, and furnished 
in sufficient quantity, the infant should be nourished exclusively 
by the breast. Not even the mild and simple fluid just men- 
tioned should be allowed, unless some special reason exist for 
the use of additional nourishment. It seldom occurs in 
healthy mothers, that the quantity of milk supplied by the 
breast is not sufficient to afford adequate nourishment to the 
child for the first two or three months, and, in general, much 
longer, without the necessity of any additional artificial food. 

Ihe infant should be nourished exclusively by the breast 
until the first teeth make their appearance. No other kind of 
nourishment whatever should be allowed before this period, 
unless from deficiency of milk or some other cause, the use of 
additional nourishment becomes necessary. After the first 
teeth have come out, small portions of barley water, thinij 
prepared arrow-root, or a mixture of equal parts of cow's mill 
and water, may be given two or three times daily, in addition 
to the nourishment drawn from the breasts. I do not mean to 



Nourishment of Infants. 105 

•ay that, wheD the child arrives at this stage, it becomes neee* 
fary, or even proper, as a general rule, to exhibit any addi- 
tional articles of food. In general, however, the simple and 
mild liquids just mentioned may be given at this period with 
very little risk of unpleasant consequences, for the digestive 
organs have by this time acquired a degree of power and 
activity sufficient to obviate the painful and disturbing effects 
which would arise from the use of such food during the first 
four or five weeks after birth. It is also of much consequence 
that the food should be introduced into the stomach as 
gradually as practicable. This can be most conveniently done 
by causing the infant to suck the fluid from a bottle, furnished 
with the usual tube, the mouth-piece of which is pierced with 
a small opening. By this contrivance, the child will receive 
its food in the same gradual manner as when nourished a 4 , the 
breast, and it will rarely take more than its appetite calls for, 
an error which is frequently committed when fed with a spoon 
After the seventh month, small portions of the preparations of 
food just mentioned (such as corn starch, pulverized crackers 
with milk and water to soften them, gruel, made of oatmeal 
or wheat flour, &c.,) should be given at regular periods, three 
or four times daily. This will prepare the infant for the sud 
den change which it has to undergo, in the character of it* 
food, when it is weaned, and thereby tend to lessen the liabil- 
ity to unpleasant consequences from the change. Infants who 
have been moderately fed with suitable articles of food some 
time previous to weaning, almost always accommodate them- 
selves much more readily, and with much less uneasiness to 
the change, than such as have seldom or never received any 
other nourishment than that which they draw from the 
mother's or nurse's breasts. 

Mothers ought never to delegate the suckling of their in- 
fants to others. This sacred office should rest with the mother 
alone. The mother who submits the suckling of her infant to 
another, while her own breasts are ready to furnish an ample 
supply of milk, can scarcely possess an amiable and moral heart. 

It can scarcely be doubted that the mother's milk is, in gen- 
eral, better adapted to the constitutional temperament of her 
offspring than that furnished by others. Besides, when the 
suckling of the infant is submitted to a nurse, it is liable io 
various sources of injury and disorder, which are, in a great 
degree, if not entirely, obviated when this important duty ia 
performed by the mother. ISTo hired nurse can be depended 
on to give the tender care, and have the affectionate regard, 
Io* u child that its own mother has. 



106 Nourishment of Infants. 

Unfortunately, however, mothers are not always In a condi 
Hon that enables them to suckle their own infants, and the 
employment of a wet-nurse, or recourse to artificial nursing, 
is unavoidable. The causes which may prevent a mother from 
nursing her child are : A decided deficiency or total failure in 
the secretion of milk, in consequence of disease or torpor of 
the breasts ; a bad state of milk, rendering it decidedly preju- 
dicial to the health of the child ; the presence of a morbid 
taint, or some communicable chronic diseas , in the mother's 
system j when suckling gives rise to pailful or dangerous 
affections in the mother, as ^olic, cough, distressing nervous 
affections, great weakness, epilepsy, &c. 

When causes of this kind render it improper or impractica- 
ble lor the mother to nurse her child, it then becomes a ques- 
tion whether a wet-nurse should be employed, or artificial 
nursing resorted to. It would, in general, be much better to 
nurse the child artificially, under the eye of its mother, than to 
place it entirely at the mercy of the wet-nurse. Nurses, 
doubtless, are sometimes found to whom a child may be safely 
intrusted ; but experience has but too often shown that the 
reverse is the case. 

Attention must also be paid to the previous and present 
health of the nurse. ~No woman who has led a debauched 
course of life, even though reformed, can be regarded as a 
perfectly safe nurse, however careful and attentive she might 
otherwise be. Females of this description are apt to have 
their systems contaminated with some morbid taint, which 
may give an unwholesome quality to the milk, and injure the 
child's constitution. The existence of scabby or scaly erup- 
tions on the skin, unless they are of transient character, and 
of chronic ulcers, particularly on the legs, should be regarded 
as sufficient objections, to a nurse. A manifest scrofulous 
habit, also, is decidedly objectionable. The age of the milk 
is another point of considerable importance. Milk that is six 
or seven months old seldom agrees well with infants during 
the first two or three months after birth. In general, the milk 
becomes much more rich and nutritious after the fourth 
month than it is previous to this period ; and raiik of this 
kind, from its requiring stronger digestive powers than 
younger milk, often gives rise to much disturbance of the 
stomach and bowels in new-born infants As a general rufe, 
therefore, the age of the milk should not vary much from that 
of the child, up to about the fourth month. After this period, 
snick % relation between the ages of the milk and child is not 
of much importance — for a child five or six months old and 



Utouruhment of Infants. 107 

upwards, may be nourished by a fresh breast witL entire 
safety. 

The occurrence of the menstrual evacuation during nursing, 
k almost invariably attended with diminution and deteriora- 
tion of the milk, and constitutes a well-grounded objection to 
a wet-nurse. This is more especially the case during the first 
three or four months of infancy. "When a child at this early 
period is put to the breast of a nurse who menstruates, it 
rarely fails to experience derangements of the stomach and 
bowels. After the seventh or eighth month of age, there is 
much less inconvenience and disorder to be apprehended from 
this source; but, even at this advanced period of infancy, the 
milk of a nurse, thus circumstanced, may give rise to disturb- 
ances in the digestive organs, and should, if possible, "be 
avoided. Nature here, as elsewhere, is a safe guide. We 
perceive that menstruation is almost universally suspended 
during the period of suckling ; and we may presume that this 
arrangement of nature is designed for some useful purpose — 
for the well-being, doubtless, of the infant. Nature, there- 
fore, as well as experience, indicates the propriety of with 
holding the breast from the child when, from constitutional 
peculiarity, or some accidental influence, the monthly turn* 
make their appearance in the nurse or the mother. 

A nurse who has but one good breast should never be se- 
lected. A child suckled by one breast only, is apt to contract 
the habit of squinting, from having its eyes constantly directed 
to one side. Some attention should also be paid to the nurse's 
nipples. If they are very small, the child will be apt to 
fatigue itself in sucking, without being able fully to satisfy* its 
wants. This defect can seldom be properly remedied. The 
practice of drawing out the nipples by suction, with a pipe or 
bottle, will be of advantage; but when the nipples are veiy 
small, and deeply imbedded in the breast, it can scarcely re- 
medy the evil. In some instances the nipples yield the milk 
so freely, that the child is continually harassed by a sense of 
strangulation, while suckling, from inability to swallow as ra- 
pidly as the milk issaes into its mouth. This may, in general, 
be remedied by passing a piece of fine tape or elastic pretty 
firmly round the base of the nipple ; or the nurse may com- 
press the nipple moderately between the first and second 
fingers, while the child is suckling. 

Finally, particular regard should be had to the temper and 
moral habits of the nurse. An irritable, passionate, and sour 
tempered female, is but illy suited for this important duty 
Mot only is the child liable to be maltreated by a nurse of this 



108 Nourishment of Infants. 

character, daring the fits of ill-nature and passion ; but th* 
most serious and alarming effects may be produced on its ten- 
der organization, by the milk of such a nnrse. It is well 
known that violent anger, and habitual sourness of temper are 
peculiarly apt to give a pernicious quality to *;he milk. Chil- 
dren have been thrown into convulsions, by suckling soon after 
the nurse has been agitated by violent anger, rage or fright ; 
and alarming vomiting and purging is particularly apt to 
occur from this cause. Indeed, every kind of inordinate ex- 
citement, or depression of the mind is unfavorable to the 
secretion of healthy milk. Protracted grief, sorrow, or mental 
distress and anxiety in the nurse, seldom fail to exert a pre- 
judicial influence on the health of the nursling. This 
circumstance ought not to be overlooked, in choosing a wet' 
mirse. 

Artificial Nursing. — Under judicious management, infanta 
will, in general, experience no particular inconvenience from 
a course of artificial nursing ; and, as a general rule, this mode 
of nourishing children, when properly conducted, is upon the 
whole preferable to the employment of a wet-nurse, whose 
competency and fitness is doubtful. This preference, however, 
is founded rather on the greater risk which the child incurs of 
being maltreated and neglected, when submitted to the ex- 
clusive care of a wet-nurse, than when nursed artificially, under 
the immediate superintendence of a parent. 

There are circumstances, in relation to the condition of the 
child, which render the employment of a wet-nurse, notwith- 
standing all the risks that have been mentioned, preferable to 
artificial nursing. Very young, and peculiarly delicate and 
i'eeble infants, seldom do well when raised by the hand. Fresh 
and wholesome milk from the breasts of the mother, or a 
healthy nurse, is almost indispensable to the well-being of an 
infant thus circumstanced. The same observations apply to 
infants, whose stomachs and bowels are peculiarly weak and 
irritable. Finally, if upon trial, the slightest and most appro- 
priate kinds of artificial food are found to disorder the 
stomach and bowels, the life of the infant will very probably 
depend on its being nursed by a fresh and wholesome breast. 

Sometimes the mother, though incapable of supplying 9 
sufficient quantity of nourishment by the breast, is still able 
to furnish small portions of wholesome milk, and when this it 
the case she ought, by all means, to continue suckling the child, 
in conjunction with the use of artificial nourishment. Par- 
ticular care should be taken to keep the bottle perfectly clean 
and sweet. It should be well washed, both inside and out- 



Nourishment of Infants 109 

lide, with hot water, every morning and evening. The sam« 
food should not be suffered to remain in the bottle more than 
three hours. After the child has satisfied its appetite, no new 
supply of food should be added to what may have been left. 
The quantity of nourishment put into the bottle, should not be 
much greater than what may be deemed fully sufficient for 
one nursing. By these precautions the food will always be 
sweet, and free from offensive or irritating qualities. Nursing 
bottles are now easily obtained in almost every part of the 
country. When the child uses the bottle, it should be taken 
up and supported in an easy position, on the lap or arms of 
the nurse, imitating the position of the mother's breast. The 
child should be kept quiet for at least thirty or forty minutes 
after having received its nourishment. Rest is particularly 
favorable to digestion. 

Children, who are entirely nursed by artificial diet, should 
be restricted to the use of the milk-and-water mixture men- 
tioned above, until several teeth have made their appearance. 
They will, in general, enjoy more perfect health and thrive 
better, when nourished exclusively with this simple food, than 
under the use of any other nourishment that can be made. 
After the third month, however, the proportion of milk should 
be somewhat increased : namely, three parts of milk to one 
part of water. After the first teeth are protruded, the food 
may be a little more varied and substantial. Grated crackers 
Jissoled in warm water ; oat-meal gruel ; liquid preparations of 
arrow-root, tapioca, or sago ; milk thickened with rice flour, 
and thin pap, may be allowed in moderate quantities along 
with the ordinary milk-and-water mixture, when these pre- 
parations do not agree with the child's stomach, they should 
be used with an equal portion of weak mutton, chicken, or 
beef broth, clear and well freed from fat. A mixture of this 
kind is, in general, easily digested, and rarely causes any un- 
pleasant effects, when used after the first teeth have made their 
appearance. 

After the first grinding teeth are protruded, weak broths, 
elightly thickened with oat-meal, rice nour, arrow-root, or grat- 
ed crackers, mixed with milk, constitute, in general, the most 
appropriate articles of nourishment. A small portion of stale 
bread may also be allowed, two or three times daily, at this 
stage of infancy. The animal food given to young children 
should be plainly roasted or boiled. Fried and broiled meats, 
and all food heated a second time, by hashing or mincing, being 
less digestible, should be avoided. Many people, from a mis* 
taken expectation of strengthening weakly children, give them 



110 Nourishment of Infants. 

more animal food, and sometimes twice or thrice a day : but 
it will be found much more frequently to add to debility 
than to the increase of strength. Those children, on the whole, 
who eat the least animal food, are the most healthy. Nothing 
is more absurd than the notion that, in early life, children re 
quire a variety of food. 

The peculiarly excitable state of the system during teethings 
and the consequent tendency to feverish irritation, render the 
free use of animal food decidedly objectionable during this 
stage of childhood. Small portions of the more digestible 
meats may be allowed to healthy children, once daily, with 
little or no risk of injury ; but they should never be permitted 
to form the principal part of the food. The lean parts of mut- 
ton, lamb, tender beef, game, and fowl, should be selected 
Veal, pork, pig, goose 9 duck, and all kinds of salted meata 
being of much more difficult digestion, can seldom be usea 
without impeding digestion, and finally injuring the tone of 
the stomach. Yeal is decidedly the most objectionable of a'J 
the meats in common use for children. Fresh fish, boiled, and 
taken in moderate portions, seldom disagrees with the stom- 
achs of children, and may be used, occasionally, with perfe»34 
propriety. Soft boiled eggs, too, form an appropriate article 
of nourishment for children after the first teeth have come out. 
"When fried, or boiled hard, they are altogether unsuitable 
Strongly seasoned meats, compound dishes, hashes, meat pies, 
and pastry, are to be wholly rejected. 

The introduction of fresh food into the stomach before that 
which was previously taken is entirely digested, seldom fails to 
operate injuriously. As a general rule, from three to four 
hours may be regarded as a suitable interval between the 
meals. If the child requires nourishment between the regular 
meals, small portions of liquid food, such as milk, &c, should 
be used. When solid animal food forms a part of the diet of 
children, it should be taken at noon, or in the forenoon. 

Pure water, with or without small portions of milk, con- 
tit ates the best drink for children. 

Candies and Sweetmeats. — Indulgence in the use of sweet- 
meats is a copious source of disease and mortality during 
childhood. Fruits preserved with their skins, as raisins, are 
particularly pernicious. The skin of all fruits is of dimcull 
digestion. 

The conduct of parents, in relation to this subject, is oftei 
extremely irrational and pernicious in its consequences. Thej 
would not themselves venture on the frequent and free use oi 
jsonfectioneries of this kind ; and yet will indulge their chil 



Nourishment of Infants. Ill 

&ren without scarcely any restraint, in the use of thea« 
pernicious luxuries. The sicklier and wealcei the child is, the 
more apt, in general, is it to be allowed these destructive gra- 
tifications. The pale, feeble, and sickly child, whose stomach 
is hardly able to digest the most simple and appropriate food, 
is sought to be appeased and delighted by the luscious and 
scarcely digestible articles of the confectioner. Indigestion. 
bowel irritation, terminating often in ulceration and incurable 
diarrhoea, are the frequent consequences of such conduct; and 
at best, such indulgence must prolong the feeble and sickly 
condition of the child, and not unfrequently eventuate in per- 
manent debility. 

With regard to the use of fresh fruits, writers, on this 
subject, have expressed different opinions. Apples, peaches, 
and apricots, (freed from the skin,) when perfectly ripe and 
mellow, may be occasionally allowed to children, in moderate 
portions, with entire safety, unless the stomach and bowels be 
■very weak and irritable. In children of a costive habit, the 
temperate use of these fruits may even have a beneficial effect. 
by their tendency to excite the action of the bowels. Pears, even 
of the tenderest kinds, appear to be much more indigestible 
than ripe apples or peaches. Stewed or roasted fruits, par- 
ticularly the two latter kinds, are, in general, well adapted to 
the digestive powers of young children, and may be allowed 
occasionally, with perfect propriety, provided they are not very 
eour. When the acid or sourness prevails to such a decree as 
to require the addition of sugar to render them sufficiently 
palatable, stewed or roasted fruits of this kind rarely agree 
well with weak and delicate stomachs, and cannot be allowed 
to young children without considerable risk of injury. 

In general, all fruits having a firm cuticle or skiL, such as 
grapes, whortleberries, &c, are improper articles of food for 
children. The pulp of grapes, freed from the seeds, rarely 
causes disorder in the bowels when taken in modeiation.. — 
Fruit that contains small, hard and insoluble seeds — such as 
Btrawberries, blackberries, currants, &c, are particularly apt, 
when taken freely, to disorder the stomach and bowels. The 
seeds, resisting the digestive powers, irritate the mucous mem- 
brane of the bowels; and when, from previous causes, this 
membrane has become enfeebled and irritable, they may rea- 
dily excite dangerous irritation. Small insoluble bodies of 
this kind, frequently remain lodged in the folds of the bowels 
for many days and even weeks, and give rise to severe and 
unmanageable disorders cf the bowels. 

Cherries are among the most pernicious fruits in common 



112 Nourishment of Infants. 

use, and ought to be wholly excluded from the list of artielei 
with which children may be occasionally indulged. Even 
when eat without the stones, they are peculiarly apt to derange 
the bowels ; and when swallowed with the stones, which, with 
children, is not unfrequently the case, they are capable of pro- 
ducing violent aud even fatal diseases. Most alarming and 
fatal consequences have resulted from the irritation of cherrj 
stones lodged in the bowels. Convulsions, inflammation, and 
harassing diarrhoea are among the affections which are apt to 
arise from this cause. All fresh fruits have a tendency to ex 
cite, more or less strongly, the action of the bowels. As a 
general rule, therefore, every kind of fresh fruit is improper 
for children whose digestive organs are weak and irritable, or 
who are habitually liable to disorder of the bowels. 

Exercise. — Uncertain and awkward motions of the arms — 
stamping with the legs, and drawing them up, are the first 
feeble attempts which the infant makes in the use of his mu& 
cles. But even these muscular exertions appear to be indis- 
pensable to the preservation of its health and the propei 
development of its powers ; and it should be an especial object 
of care to allow entire freedom of motion, several hours daily, 
by avoiding all modes of dress and position tending to restrain 
the free use of the extremities. With this view, the infant 
should be taken from its bed two or three times a day, and 
laid on his back upon a soft mattress, or any other level and 
slightly resisting surface, and divested of every thing calcu- 
lated to restrain the motion of its limbs and body. Confining 
an infant's feet in long under-clothes is decidedly objection- 
able, after they get to be a few weeks old. Children who are 
frequently permitted to exercise their muscles in this way, will 
learn to use their limbs and walk earlier than those who are 
seldom allowed this freedom of voluntary action. 

Carrying. — This should be commenced as early as two 
weeks after birth, provided the infant be not unusually feeble ; 
and it should be daily attended to, as one of the regular and 
indispensable duties of nursing. The manner, however, in 
which very young children are usually carried or exercised, in 
extremely reprehensible, as it is calculated to give rise to very 
unfortunate consequences in relation to the health and regular 
conformation of the child's body. We allude, particularly, to 
the common practice of carrying infants with their bodies in 
an erect position, before the backbone and muscles have ac- 
quired a sufficient degree of firmness and activity to support 
tne body and head in this posture. The child is usually car- 
ried "by the nurse pressing its thighs and hips, with the left 



Nouruhmmt of Infants. 113 

forearm, against her body, whilst its body is balanced in an 
upright posture, by resting lightly against her bosom. Thus 
the whole weight of the infant's body rests upon the feeble 
and yielding backbone, while the unsupported head is, in 
general, suffered to lean constantly to one side, or to roll 
about in every direction. This mode of carrying infants must 
interfere, very materially, with the regular and symmetrical 
development of the body. The feeble backbone, yielding to 
the weight of the head and body, is always curved outwards 
while the infant is held or carried in the erect position ; and, 
when this is daily repeated for several hours, as is frequently 
the case, the back is liable to become permanently bent or dis- 
torted. A habit, too, of leaning the head to one side is some- 
times contracted by the child ; and, from the violent mannei 
vi which the head is liable to fall from side to side, serious and 
even fatal injury may be inflicted on the spinal marrow of the 
neck. But even after the spine and its muscles have acquired 
a sufficient degree of firmness, to enable the child to support 
its head and body in an erect position, without difficulty, it in- 
curs considerable risk of injury from the usual practice of 
carrying it almost exclusively on one arm. When the child 
is carried almost whollv on one arm, it is apt to acquire the 
habit of leaning to one side, which it is always very difficult to 
correct. The child, also, when carried in this manner, usually 
throws one of its arms around the neck of the nurse, in order 
to support itself more steadily in the erect position ; and of 
course always with the same arm, when the side on which it 
is carried is not changed by the nurse. In consequence of this 
position, the shoulder-blade and side of the chest are liable to 
Deforced upwards and outwards, which may result in perma- 
nent distortion. 

The backbone and its muscles seldom acquire sufficient 
Btrength and fimness before the end of the third month, to en- 
able the child to support its body in an upright position, with- 
out inconvenience or risk. Until this pow T er is acquired, the 
infant should not be carried, or suffered to sit, with its body 
erect, without supporting it in such a manner as to lighten the 
pressure made on the spine, and aid it in maintaining the up- 
right posture of its head and body. But even when thus sup- 
ported by the nurse, it should not be kept in an erect position 
more than one or two minutes at a time, until it is two months 
old. At first (a few days after birth) the infant should be 
taken from its cradle or bed, two or three times daily, and laid 
on its back, upon a pillow, and carried gently about tba 
chamber. The best mode of carrying very young infants is to 



114: - Nourishment of Infanta. 

Ulj them into a small, oblong basket. By this contrivance a 
gentle and agreeable swinging or undulating motion will be 
communicated to them ; and the sides of the basket being three 
or four inches higher than the child's body, a cover or netting 
may be thrown over it, without restraining the free motion ofiti 
limbs. After the third or fourth week, the child may be carried 
lying in the arms of a careful nurse, in such a way as to afford 
entire support to the body and head. It is painful to see the 
Tiolent and generally abortive efforts which the infant makes to 
steady its little head, when raised into a sitting posture. It will 
sometimes succeed in balancing its head for a moment, to the 
great delight of the fond mother ; but the effort is almost in- 
variably speedily followed by a sudden and often violent 
rolling of the head from side to side, which cannot but be in- 
jurious. 

All rapid, whirling and jerking or jolting motions are calcu- 
lated to injure the health of infants. Running or jumping 
with an infant in the arms, descending rapidly a flight of stairs, 
whirling round, etc., ought to be rigidly forbidden. The prac- 
tice of supporting very young infants in a sitting posture on 
the knee and jolting them violently cannot be to severely cen- 
sured. It is not uncommon to see mothers and nurses jolt in- 
fants in this manner, with a violence that threatens disloca- 
tion. Tossing them rudely on the arms, is equally reprehen- 
sible. These violent agitations " powerfully affect the delicate 
organization of infants, and may be productive of spasms, epi- 
lepsy, and apoplectic fits." Gentle and cautious tossing on 
the arms affords an agreeable exercise of the body, and may 
b»3 beneficial by the moderate agitation which it causes in the 
internal organs. 

With infants predisposed to diseases of the head, strong 
rocking should be particularly avoided. 

Riding in a Carriage. — This is an excellent mode of afford- 
ing suitable exercise to infants, and may, with great propriety, 
be employed as an occasional substitute for carrying in the 
arms. 

The body of the carriage should be long enough to permli 
the infant, when quite young, to lie down at full length , and 
the sides ought to be sufficiently high to prevent its falling or 
rolling out. Like carrying in the arms, this mode of exercis- 
ing infants is liable to be conducted very improperly. Th:a 
duty is usually entrusted to children or young girls, who being 
generally more disposed to consult their own sportive inclina- 
tions than the comfort and safety of their charge, are apt to 
draw the carriage along with great rapidity, paying little 01 



Nourishment of Infants* 115 

no attention to the roughness or unevenness of the ground 
over which they pass. After the child has acquired some de* 
gree of strength, it should be placed in a half sitting posture, 
with its head and back well supported by pillows, etc. 

Walking. — After the infant has acquired sufficient strength 
to support itself in the sitting posture, it should be placed on 
a soft carpet several times daily, and surrounded with its toys* 
When thus left to the free use of its limbs, it will soon learn ta 
crawl. The common practice of teaching children to walk by sup- 
porting them prematurely on their legs, and leading them for- 
ward w'thout allowing them the advantage of having their mus- 
cles previously strengthened, and in some degree brought under 
the commands of the will, by crawling, is objectionable on vari- 
ous accounts. It seldom fails to produce more or less unnatural 
curvature of the legs ; and in infants of a scrofulous or ricketty 
habit, it may readily give rise to distortion of the spine and 
round shoulder. Children who are permitted to exercise their 
muscles by crawling, generally acquire a much firmer step, 
and enjoy more robust health than " those who have been 
taught to walk before the crawling exercise." 

If we are earnestly desirous of training up our children in 
•uch a manner that they may acquire a firm step and well- 
formed limbs, we shall gain our purpose much more certainly 
and safely by pursuing this gradual and cautious mode of 
teaching them the use of their legs, than by the more common 
practice of placing them prematurely on their feet, without 
permitting them first to learn to crawl. 

Leading-strings and go-carts, formerly so much in use, are 
now, very properly, almost universally abandoned. The very 
common practice of teaching infants to walk by holding them 
by one of their hands, is very wrong. When led in this way, 
the child's arm is continually, and often forcibly, extended up- 
wards : if it happen to lose its balance, or trip, or if its legs 
are yet too feeble to support itself long in the erect posture, 
the whole weight of its body is often suspended by one arm. 
Frequently, too, it is entirely raised from the ground ly one 
Arm, in order to help it over some obstacle, or to hasten its 
progress over a rough and difficult piece of ground. It is easy 
|o perceive that thjs practice must necessarily, and in no in- 
considerable degree, tend to draw the shoulder and side of tha 
Jiest out of their natural position ; and when frequently re- 
peated, to give permanent deformity to these parts. 

K ursery -maids seldom exercise sufficient care in this respect. 
Too indolent to carry the infant in their arms, as they are 
directed and mpposedto do } they are apt, as soon as they are m/ 



116 Nourishment of Infants. 

\mger observed, to place the child on the ground, and to hurry 
or rather drag it along, in the most careless and unfeeling 
manner. Of a similar, but still more reprehensible character, 
is the practice of raising infants from the ground by both arms 
and swinging them about in the air. 

After children have acquired the entire use of their legs 
walking is decidedly the best exercise they can take. Parents 
©light not to intimidate their children by inspiring them with 
ft constant dread of falling or hurting themselves. The custom of 
exaggerating the dangers incident to their usual sports — and ot 
plying them continually with admonitory injunctions against ac- 
cidents when they are engaged in their amusements, is calculated 
to favor the occurrence of the very accidents which they are 
meant to obviate, by the timidity which these perpetual lessons 
of caution and fear almost inevitably inspire. When the ground 
is soft, it is much better to let the child take the chance of two 
or three falls, and give it full scope for the exercise of its limbs, 
by running about until it is satisfied. When children fall o* 
hurt themselves, they should not be soothed by expressions ol 
extreme pity and sorrow ; for plaintive words and e spressiona 
of great sorrow tend very effectually to render them effeminate 
and timid. Children who are thus accustomed to excessive com- 
misseration, seldom fail to acknowledge this tender sympathy, 
by straining their little lungs to the utmost by crying on everv 
slight injury they receive. 

After children have passed through the period of teething, 
they should be encouraged in the pursuit of active amusment 
out oi doors, as an essential and regular part of physical dis- 
cipline. The practice of obliging children t' • remain within 
doors, and to con over their lessons between or after school hours, 
is a barbarous " march of civilization." These intervals should 
be devoted to innocent amusement and bodily exercise. 

Exposure. — Infants ought to be early accustomed to the 
fresh and open air. The practice of confining them, during 
the first five or six weeks, to close and heated rooms, has a di- 
rect tendency to impair the energies of the system, and to 
impede its healthful development. Pure air is most grateful 
to the feelings of children. After having been carried out, 
but a few times, they evince, even at a very early age, a 
•trong desire to return to the open air. While yet on tha 
arms of the nurse, they anxiously point to the door, and make 
efforts to approach and open it. When they can scarcely crawl, 
they instinctively advance towards that part of the room from 
which they have a prospect of escaping. 

When the weather is clear and of a mild temperature, infant* 






Nburishmen t of Infants, 117 

rfiosld \e canied into the open air once or twice daily, assoo:; 
§& thev are three or four weeks old. During cold and damp 
weather, they should be occasionally conveyed into an adjoin 
ing well-aired room : avoiding, however, strong currents of air, 
or sitting with them near an open window. Important as the 
enjoyment of fresh air is to the health and comfort of infants, 
care should be taken to accustom them graduaDy to the im- 
pressions of the external air — more especially when tht 
atmosphere is cold and damp. The practice of exposing ehil 
dren, soon after birth, at once to the open and cold air, with 
the view of " hardening them," as it is called, is attended with 
considerable risk of injury, and should not be permitted by 
parents, except when the weather is clear and very mild. 
Even in summer, the infant should not, as a general rule, be 
carried at once into the external air, without having been pre- 
viously accustomed to the air of a well-ventilated chamber. 
After the child is three or four days old, it ought to be con- 
veyed, several times daily, into an adjoining room having, at 
first, only the windows open, and in four or five days after- 
wards, the doors also, so as to admit a free circulation of the 
air through every part of the room. This having been prac- 
tised for ten or twelve days, the child may then be carried out 
of doors, and permitted to enjoy the pure and open air. At 
first, it should not be allowed to remain c^jt of doors more 
than five or ten minutes at a time, but gradually extended. 
Hanging up the linen of children, or drying their diapers in 
thepiaee where they sleep, is very improper. 

Weaning. — The> only thing that is usually regarded by 
mothers, in fixing on the time for weaning, is the age of the 
infant. The child is suckled until it attains a certain age, 
without any regard to the development of its digestive powers, 
or the state of its health and constitutional vigor. By thi« 
course, children may be kept at the breast, long after the vigor 
oi the digestive functions, and the demands of the system re- 
quire a more substantial and nutritive diet ; and on the other 
hand, they may be separated from the breast before the stom 
ach has acquired sufficient energy to digest with due facility 
a stronger and less congenial food. The progressive develop 
ment of the digestive powers, and the demands of the organi< 
sation in relation to nourishment, are very various ainon^ 
different infants. It is particularly important that the con 
dition of 'nfants, with regard to these circumstances, should 
be consulted in regulating the period of nursing, The ob 
vious correspondence which exists between the successive 
appearance of the teeth, aud the development of the dige* 



118 Nourishment of Infants. 

tire powers, afford us a safe guide in relation to thii gufe 
ject. 

The progress of teething is, doubtless, our safest guide in re- 
gulating the nourishment of infants, and in deciding on the 
period at which they may with propriety be put on the ex- 
elusive use of artificial food. Not unfrequently, however, 
circumstances of an irregular or morbid character render it 
expedient, or even indispensable, to wean the child, before it 
has attained the age and development which, under ordinary 
circumstances, would be deemed requisite to justify its final 
separation from the breast. 

The mother may be affected with some constitutional disease, 
which may so contaminate her milk, as to render it highly 
injurious to the child's health, if she continues to nourish it at 
the breast. Mothers, affected with scrofula, or ulcerated can- 
cer, should, on no account, suckle their infants. 

The mother may also be so exhausted and debilitated by an 
attack of some acute disease, and the measures requisite to 
subdue it, that she cannot continue to suckle her infant, with- 
out increasing her prostration and superinducing a train of 
alarming and highly distressing affections. The same difficulty 
is apt to occur in mothers of a feeble, delicate and nervous 
habit of body, particularly when the digestive powers are 
weak, or so disordered that nourishing and substantial aliment 
cannot be taken. Under these circumstances, suckling can 
seldom be continued without producing the worst effects. 

Many young ladies, on becoming mothers, are incapable of 
supporting the constant drain to which the wants of their in 
fants subject them. They lose their good looks, become 
gradually weaker and paler, and, as their strength declines, 
they become more and more afflicted with a variety of harass- 
ing nervous affections. Medicinal means are of no permanent 
advantage. They may procure more or less temporary miti- 
gation of the symptoms, but they are wholly inadequate to 
the removal of the malady. Nothing hut weaning will suffice 
—and the entire separation of the child from the breast ia 
generally soon followed by a progressive subsidence of the 
sufferings of the patient. 

On the part of the mother, the effects of unduly protracted 
nursing are sometimes extremely pernicious. We not unfre- 
quently see women pale, debilitated, and constantly tormented 
with dyspeptic and nervous affections, suckling their infanti 
for eighteen or twenty months, and occasionally mu^h longer 
without suspecting that their sufferings and ill-health are thf 
result of exhaustion from the constant drain of nursing. 



Nourishment of Infants. 119 

Many u\ others are able to suckle their children until they 
arrive at the proper period of weaning without the least in- 
convenience, who, nevertheless, w T ill suffer very serious de- 
rangements of health when the nursing is extended considera- 
bly bey on $ the time which nature points out as the proper 
period for terminating it. 

On the part of the infant, also, suckling, when continued 
much beyond the proper period, is apt to exert a highly inju- 
rious influence. It is well known that after the eleventh or 
twelfth month the milk almost invariably becomes diminished 
in quantity, as well as more or less deteriorated in quality / 
and, in proportion as the nursing is protracted, so will it lose 
more and more its nutritious and wholesome character. In 
many instances, indeed, the milk begins to deteriorate as early 
as the nintli or tenth month, corresponding in this respect 
with the proper period of weaning as it is usually indicated 
by the progress of teething. Children who are suckled an 
undue length of time generally gradually lose their fresh and 
healthy appearance. The countenance becomes very pale, 
and acquires a languid, fretful, and sickly expression. 

In some instances the milk loses its wholesome properties at 
an early period, without any very serious or obvious derange- 
ment of health in the mother's system. When this occurs, 
the infant often throws up the milk, soon after nursing, and 
becomes harassed with colic, griping, acidity, and diarrhoea, 
attended with paleness, debility, emaciation, and frequently 
with scabby eruptions about the face and head. If the child 
becomes affected in this manner, when nourished exclusively 
at the breast, we may presume that the milk has become de- 
praved a*nd injurious to its digestive organs. If any doubt 
exist as to the agency of the milk in the production of the 
disorder, the breast should be withheld from the child as long 
as can be done without any particular inconvenience to the 
mother, and artificial nourishment, or the milk of a nurse, 
substituted. If the mother's milk has been the cause of the 
ehild's illness, an obvious abatement of the symptoms will 
■ oon take place ; and should this occur, the child ought to bo 
gradually entirely separated from the mother. 

The recurrence of the menses, during nursing, exerts, in 
many cases, a decidedly prejudicial influence on the proper- 
ties of the milk, and often renders weaning necessary before 
the usual period of separating the child from the breast. 
When the mother finds the child becoming sickly, feeble, and 
annoyed with disorder of the stomach and bowels, after her 
monthly sickness has returned^ or after she finds herself in • 



120 Diseases of Children. 

state of pregnancy, and relief is not obtained, in due time> 
froir the use of appropriate remedial means, the child ought 
to be gradually weaned. Should a woman with an infant at 
her breast, again become pregnant, one of two things will 
usually take place : either she will miscarry, or her milk will 
become impoverished in quality and diminished in quantity. 
It was not intended by nature that the processes of pregnancy 
and nursing should go on simultaneously ; but, on the con- 
trary, that the one should commence when the other had ter* 
minated ; and experience sufficiently proves, that they will 
not proceed well together. 

Attention should also be paid to the season of the year, in 
fixing on the period of weaning. In general, weaning may bfl 
accomplished with less inconvenience and risk of unpleasant 
consequences to the child, during the mild months of April, 
May, September, October, and the early part of November, 
than whilst the weather is inclement. Exercise in the open ail 
is always highly beneficial to the child at the time of weaning. 
It tends to fortify the system of the child, and to enable its diges- 
tive organs to bear, without inconvenience, the change of nou- 
rishment. In consequence of the peculiar tendency of warm 
weather to excite summer complaint, particularly in cities or 
large towns, it is in general inexpedient to separate children 
from the breast during the months of June, July and August ; 
for the transition from the mother's milk to an exclusive arti- 
ficial nourishment during this season, has a decided tendency 
to favor the occurrence of this dangerous disease. Neverthe- 
less, should the child be suffering from a deteriorated state of 
the milk, it ought to be separated from the breast without any 
regard to season ; for a bad condition of the milk would doubt- 
less be more injurious in this respect than a suitable artificial 
nourishment. The child should, at the same time, have tha 
proper bathing, out-door exercise, etc. 

DISEASES OF CHILDREN. 

Difficult Tkething. — Teething is not usually attended witlj 
much suffering or danger ; yet when there is much predispo* 
sition to disease during this process, any exciting cause may 
produce violent and dangerous symptoms. The first teeth 
usually begin to penetrate the gums about the seventh mouth 
of infancy — they sometimes, however, appear as early as the 
third or fourth, and in some cases as late as the twelfth or fif 
teenth. In difficult teething there is redness and tenderness of 
the gums, increased flow of saliva or spittle, thirst, looseness of 
the bowels, slight fever, restlessness and sometimes eruption! 



Diseases of Children. 121 

Mil the skin. In the more severe cases there are often ulcers of 
the gums, diarrhea or dysentery, inflammation of the brain or 
Dowels, spasm of the windpipe, convulsions and death. These 
cases require perfect cleanliness, quiet, pure air, vegetable diet, 
cooi drinks, mild purgatives, and lancing of the gums. Bg 
careful not to give anything to check the bowels suddenly, in 
cases of looseness during teething, as the head is apt to become 
the seat of very serious disease in such cases, producing spasms, 
and sometimes inflammation of the brain. Giving the child, 
three or four times a day, a spoonful or two of blackberry root 
tea (cold), is about as good, in cases of diarrhea during teeth- 
ing, as anything else. Flannel should be worn next the skin, and 
let the child live on the mildest food, or the breast-milk, accord- 
ing to the age. 

Toothache. — This may occur from decay of the tooth and ex« 
posure of the nerve, from inflammation of the nerve, gums or 
membrane lining the socket, or from ulceration at the root of 
the tooth. If the tooth is much decayed, dark colored, or 
ulcerated, it should be extracted : if the pain is caused by in- 
flamed gums or socket, the gums should be freely lanced, warm 
fomentations, such as hops and vinegar, with hot water, re- 
newed every half hour, applied to the face, and a gentle purge 
administered — castor oil, one teaspoonful, syrup of rhubarb, 
one to two teaspoonfuls, or the same quantity of Rochelle salta 
in a gill of cold water. 

When the tooth has a cavity in it so as to expose the nerve 
and cause pain, the application of a piece of cotton wet in some 
stimulating medicine, such as oil of cloves, or cinnamon, or 
paregoric and camphor, or a mixture of fine salt and alum, put 
into the tooth on a piece of wet cotton, and renewed every 
half hour, will usually give relief. 

Inflamed Gums. — During the first teething the gums are 
very liable to become inflamed ; in some cases it is slight, and 
in others severe, and productive of serious consequences. The 
gums first become red, or dark-colored, swelled and painful, 
child languid, feverish, thirsty, tongue furred, appetite im- 
paired, and sleep disturbed. When the inflammation occurs 
before the double teeth appear, it often destroys the new teeth : 
and when the inflammation proceeds to ulceration — if this is. 
not speedily checked, the other teeth become black, loose, and 
decayed. There is a flow of spittle, sometimes mixed with 
blood, the breath is unpleasant, countenance pale, and some- 
times severe attacks of diarrhea. This condition is caused by 
wo much, or improper food, filthiness of the teeth, neglect to 
lance the gums in difficult teething, biting hard substances, and 



122 Diseases of Children. 

iHsoraer of the stomach. The gums should be freely scarrifiecl 
(lanced) the bowels regulated, and some astringent medicine, 
such as strong green or black tea (cold), tea made of white oak 
bark, etc., applied frequently to the gums, the teeth cleaned 
and all decayed ones extracted : the diet should be very light, 
and the general health improved by gentle tonics ; a tea made 
from a mixture of equal parts of bruised gentian root, wild 
cherrj bark, and orange-peel or sassafras bark — say one t able- 
spoonful of the mixture in a pint of boiling water, cover up 
and let stand for one hour and a half ; of this one or two table- 
spoonfuls may be taken before each meal (cold.) 

Thrush. — -.Four or five varieties of inflamed mouth are le- 
scribed by authors; but the most common of these are simple 
inflammation and thrush. The symptoms of the first are, red* 
ness and dryness of the mouth, the infant manifesting paia 
when attempting to nurse — caused by teething, bad diet, 
sharp acrid substances, cold, or over exertion of the muscles d 
the tongue and mouth in attempting to nurse from a badlj- 
formed nipple. By removing the cause, and the use of simple 
washes and mild purges, a cure is soon effected. Thrash is 
confined in its attacks mostly to nursing infants. At the be- 
ginning of an attack the child is restless, the mouth red, dry, 
and hot, digestion is disturbed, and there is difficulty in nurs- 
ing : after one or two days, small white spots appear on the 
tongue and mouth, and sometimes spread over the entire sur- 
face. In the course of the disease, patches of curdlike matter 
fall off, and the spots are again covered as before ; it sometimes 
extends backwards into the throat, or ulcerates and becomes 
both tedious and troublesome — in some cases it proves fatal. 

It is caused by improper diet, filthiness, impure air, disorder 
of the stomach and bowels, sudden stopping of diarrhea, and 
nursing from a sore nipple or a diseasec uurse. In mild cases', 
pure air, proper diet, cleanliness, inild purgatives — same a* 
those recommended in treating toothacne, and soothing washes 
(hor tes* and sage tea mixed, is very good,) for the mouth, will 
remeve the complaint. 

The first thing to be done when an infant is affected with 
thrush, is to correct the acid state of the bowels by a few grains 
of calcined magnesia — or if the bowels be relaxed, by chalk, 
following the magnesia by a half teaspoonful of castor oil. 
This may be repeated every second day. The quality of the 
milk, and the state of the nipple of the mother are to be exam- 
ined. Milk and water — two parts of the former to one of the 
latrer — in which a little isinglass should be dissolved if there 
is diarrhea, is to oe the sole addition to the mother's milk ; aU 



Diseases of Children. 123 

rogai is to be avoided. If the state of the bowels be corrected, 
the thrush will generally get well, but it is expedient to assist 
the cure by the use of a solution of borax in water — one teaspoon- 
ful to half a pint — used to wash the mouth. When the case is 
mild, the curd-like patches will separate in seven or eight days, 
leaving a healing surface below, and the mouth soon gets well, 
if it be not injudiciously scrubbed (" cleaned ") daily by the 
urse. 

Bleeding from the Nose. — This is sometimes a frequent 
and troublesome disease with children, caused by injuries of 
the nose, fullness of the blood-vessels of the head, &c. In 
robust persons troubled with dizziness and headache, it is often 
beneficial, and, unless excessive, need not be restrained ; but 
in those of a pale and weak habit, it may, if long continued, 
produce debility and dropsy. It may usually be restrained by 
the application of cold water to the head and neck, snuffing 
cold water, or alum water, up the nose, or stopping the nos- 
trils with lint or cotton. When these means fail, more effi- 
cient ones must be employed. 

Gargling a strong tea, made of white oak bark, when cold, 
in the throat, then suddenly closing the mouth, and stooping 
forward, to make the liquid come out of the nostrils, repeated 
every few minutes, if necessary, will usually stop it. Raising 
both hands above the head, while the nose is kept closed by 
an assistant, is a good and simple remedy. 

To prevent a return, bathe the head in cold water, night and 
morning, live principally on a vegetable diet, keep the bowels 
regular, and avoid exposing the head to the heat of the sun. 
Using a rough towel or a flesh brush, night and morning, to 
rub the surface of the body and lower extremities, is advisa- 
ble. 

Canker of the Mouth. — This occurs in children of weak, 
scrofulous constitution, who are ill-fed and exposed to the in- 
fluences of unhealthy habitations ; and most generally imme- 
diately after acute disease, particularly measles. The first 
gymptom of the disease is a red, hard, angry-looking spot on 
the cheek, which quickly opens into a gangrenous, (mortified) 
nicer inside the mouth, the gums become affected, the teeth 
drop out, the breath is very unpleasant, and the extending 
llceration goes on destroying the cheek and contiguous parti, 
rill it :'s either stopped or death ensues. 

As the first cause of this fearful affection is traceable to 
poverty of constitution, the first remedial measure is to nour- 
ish. The strongest meat-soup — beef-tea is the best — must b* 
^iven In small quantities, frequently repeated ; milk and eggs, 



124 Croup. 

if the little patient will take them. Wine may be allowed if 
the debility is extreme, but scarcely, if at all, should fever run 
high, and there is much heat of skin. A drachm of chlorate 
of potash is to be dissolved in six ounces of water, and to this 
added twenty drops of muriatic acid. A tablespoonful of the 
mixture to be given to a child of six years of age every four 
hours; it may be slightly sweetened. Half-grain doses of 
quinine, or an ounce of infusion (or tea) of Peruvian bark, 
may be given twice or three times in the twenty-four hours. 
A wash made of one teaspoonful of salt, dissolved in half a 
pint of water, should be frequently applied. The case ought 
to be seen by a medical man as soon as possible. 

CROUP. 

This is recognized as one of the most dangerous diseases 
of childhood. Its progress is rapid, and its treatment, to be 
successful, admits of no delay. Fortunately, if taken in time, 
it is greatly under the control of well-directed treatment. Its 
dangerous nature must ever make proper medical advice a 
necessity, but the importance of early active remedial meas- 
ures renders it, at the same time, highly desirable that treat- 
ment should be resorted to without the slightest delay. The 
great danger in croup arises not only from the possibility of 
the narrow chink in the larynx, or upper part of the wind- 
pipe, through which the air passes, becoming closed by 
swelling, but also from the remarkable product of a peculiar 
inflammation which is formed upon, or thrown out by, the 
lining membrane of the parts. This formation, " false mem- 
brane " as it is named, resembles thin leather of an ash color. 
It takes the form of the tube which it lines, and, indeed, is 
sometimes coughed up in perfect tubular portions. However, 
when this false membrane forms, death is the result usually. 

Croup may begin very suddenly. A child goes to bed, to 
all appearance perfectly well, and in the course of two or 
three hours comes a cough, which strikes even the most un- 
observant as peculiar, which falling upon the ear of the anx- 
ious parent, who has ever heard it before, tells at once of 
danger. The child seems as if it coughed through a brazen 
tube. Perhaps at first the little invalid is not awakened, and 
if now visited is found flushed and fevered, moaning slightly, 
perhaps, and restless, the breathing slightly quickened ; the 
cough comes again, the child awakes, or is awakened ; if it 
speaks, the voice is hoarse ; if it cries, hoarser still. Should 
the disease be neglected at this time, or go on uncontrolled, 
the cough, still retaining its peculiar character, becomes more 



Croup. 125 

frequent ; the breathing, quickened, is also accompanied by 
the characteristic dry wheezing occasioned by narrowing of 
the passage through which the air is drawn; the head is 
thrown back in the efforts to breathe, respiration is insuffi- 
ciently performed, and the blood being insufficiently changed 
begins to evince its deteriorated character in the blue color 
of the lips, the dusky coldness of the skin, and the affection 
of the brain which gives rise to partial insensibility or deli- 
rium. The pulse, previously quick, becomes still quicker, 
but at the same time feebler, and at last the child dies in a 
state of almost unconscious suffocation. There may, however, 
in the progress of the disease, be intervals of comparative 
ease, alternating with paroxysms of spasmodic obstruction to 
the breathing, threatening, and sometimes causing, immedi- 
ate suffocation. The average duration of a fatal attack of 
croup is from three to four days, but it may, and does, termi- 
nate much more speedily. When under proper treatment the 
disease is checked, the first best sign is the cough beginning 
to "loosen," the breathing at the same time becoming tran- 
quil, and the skin moist ; the pulse changes from its hard 
quick beat to one of a softer and a shiver character. Croup does 
not, however, invariably begin suddenly — frequently the child 
has been suffering, apparently, from common cold in the head, 
and the attack of croup seems to be a consequence of the in- 
flammatory affection of the membrane of the nose and throat 
extending into the windpipe, and taking on the peculiar char- 
acter of the more fatal disease. At other times there has 
been slight drowsiness for some days previously, but not 
sufficiently well marked to attract attention, although at the 
same time, from hoarseness not being common among children, 
its occurrence should always arouse suspicion, especially if 
the child itself, or any of the family, have suffered from croup. 
Sometimes a child will have a croupy cough for some nights 
in succession before the attack of the real formed disease ; 
and parents are apt to be lulled into security by the, fact that 
in children susceptible of croup any cough partakes more or 
less of the shrill croupy sound. Another, and highly danger- 
ous, form of croup is that in which the inflammation com- 
mences in the throat, the tonsils, and soft palate, which quick- 
ly become covered with an ash-colored membrane. At first 
the child is supposed to be merely suffering from sore throat, 
for there may be little or no cough, or embarrassment of 
breathing, but the inflammation extends downward into the 
air passages, and the croupy symptoms become developed ; 
by the time this stage is reached the case is all but hopeless. 



126 Croup. 

Fortunately this dreaded disease, the most distressing, per- 
haps, by which a parent can lose a child, is, in every form 
but the last, amenable to proper remedies, if adopted at once. 
So strikingly, indeed, is this the case, that it is very common 
to find parents taking the matter in their own hands after 
they have seen a child treated for the disease once or twice, 
keeping, as they ought to do, a supply of the proper medicines 
constantly at hand, and by their prompt application nipping 
the first attack in the bud; the medical attendant is either 
not sent for, or, if he is, it is only to find that the proper 
treatment has been followed and the disease checked. 

The great remedy in croup is emetics, or medicines which 
sicken the little sufferer at the stomach, and cause vomiting. 
A teaspoonful of the syrup of ipecac, or four grains of the 
powder, given at the very beginning of the disease, will 
usually produce vomiting in a short time; if not, let the dose 
be repeated until that effect is produced. If ipecac is not to 
be had, as is often the case, at that hour of the night, one tea- 
spoonful of powdered alum, mixed with a tablespoonful or 
two of sweetened water, given, will usually produce vomiting ; 
or, if nothing better can be had, from ten to thirty drops of 
antimonial wine, (according to the age of the child,) given 
every fifteen minutes, until it has the effect of vomiting. 

If the child is not better within an hour after the first 
vomiting, the emetic should be repeated. Besides this, apply 
some stimulating liniment to the throat, and around the up- 
per part of the chest, front and back, and also keep a piece 
of flannel bound around the throat. A mixture of turpentine, 
sweet oil, spirits camphor, and whisky, (or spirits of any 
kind,) in equal parts, will make a good liniment, applying it 
with a woollen cloth or the hand, and afterwards putting on 
flannel next the skin. If all these ingredients are not to be 
had, use such as you have, even one of them alone. Let the 
child drink freely of toast water or thin gruel. 

Besides this treatment, keep the child carefully wrapped 
up, to prevent checking the perspiration ; and also produce a 
moisture in the room as soon as possible, by means of hot 
water poured over mullein leaves, hops, sage, and horehound, 
all mixed together, or either one, if all cannot be had, using 
a large pan, pail, or dish, so that the steam arising therefrom 
will impart its moisture readily to the air of the room. And 
if the child be large enough, let it inhale frequently from an 
old tea-pot the vapor of hot water and mullein leaves, or 
some of the other ingredients mentioned above. 

Also, give a good dose of castor oil or other suitable medi- 
cine, to purge the bowels. When the child is getting better, 



Croup. 127 

be careful of a relapse. Do not suffer it to be exposed to the 
cold air out of doors till entirely well. 

If a case of incipient croup be thus treated, it will, in all 
probability, and may be, subdued without medical assistance, 
though it is certainly safer to have it ; but if the fever is ex- 
tremely high, and if the breathing has any approach to a 
crowing sound, medical attendance must be procured if possi- 
ble, and with the shortest possible delay. Always bear in 
mind that this disease must be promptly treated. 

The causes of croup are almost invariably connected with 
cold and moisture, and particularly during east winds ; but it 
may also be occasioned by the removal of wrappings from 
the throat, and exposure to a cool air when a child is heated. 
Children liable to croup are still more so after attacks of 
acute or debilitating disease. 

The prevention of croup is, of course, of the highest im- 
portance, and, therefore, the causes of it must be avoided in 
every way. Slight colds should never be neglected in chil- 
dren or families thus predisposed, but should be treated by 
confinement to the house, or to bed if requisite, by milk diet, 
diluent drinks, and by the tolu (■£• oz.) and mucilage (2 oz.) 
cough mixture, with the addition of wine of ipecac (•£■ oz.), 
one teaspoonful of the mixture every four hours ; paregoric 
should also be given to allay troublesome cough, and, in fact, 
those measures recommended in cold carried out. The sus- 
ceptibility may also be lessened by not clothing the throat 
too warmly, and by the regular practice of bathing the throat 
and chest well with cold water every morning, rubbing after- 
ward with a rough towel, till thorough reaction ensues. This 
practice is, of course, better commenced in warm weather, 
and not too soon after an attack of the disease. Flannel 
should always be worn next the skin, and care taken particu- 
larly that bedchambers and rooms children habitually live in 
are not too warm, and never occupied while the floors are wet 
after washing. A residence a distance from water is to be 
preferred. 

Spadmodic or Crowing Croup. — This disease differs very 
much from the membranous croup. It is species of convul- 
sive or spasmodic affection of the muscles of the larynx (upper 
part of windpipe), which by narrowing and closing the chink 
in that organ, through which the air passes,occasions the sound 
of the breathing to resemble that of the true inflammatory 
disease. This spurious croup is often an alarming, and some- 
times a fatal disease ; it generally occurs before the end of the 
third year of life, and in consequence of irritations acting more 
or less at a distance from the affected parts which receives the 



128 Colds and Snuffles. 

Impressions tlnoagli its nerves. Enlargement of the glands of 
the neck, affections such as eruptions of the scalp, the irrite 
tion of teething, or the presence of irritating matter in the 
bowels, may any of them give rise to this affection. It comet 
on suddenly ; the child is seized in a moment with " catching 
at the breath," struggles, the face changes color, and the veine 
are full. If the spasm be not relaxed after a few ineffectim: 
efforts at breathing, the child must die ; but if the spasm give* 
way, the air is drawn into the chest with a crowing, croupy 
sound. It is of much importance that this spasmodic disease 
should be distinguished from real inflammatory croup, on ac- 
count of the very different treatment required ; it may be 
known by the absence of fever, the stopping of the breath be- 
ing much more instantaneous than that which occurs in the 
real disease. In an affection presenting symptoms so sudden 
and so alarming, immediate remedies must be used ; a little 
cold water should be dashed on the face at once, and, as recom- 
mended by Dr. Watson, a sponge dipped in hot water applied 
to the fore part of the throat, and after removing it apply a 
flannel bandage saturated with some stimulating liniment, 
medical assistance being of course procured if possible. 

In the meantime, set the child in an upright position, with 
the head leaning forward, and exposed to the fresh air for a 
few moments, the body being at the same time well wrapped 
up. If not relieved, rub the spine (back bone) thoroughly 
with the open hand, moistened with the liniment previously 
mentioned, or any other which may be on hand. 

When the spasmodic fit is over, examine the gums, and if 
red and inflamed let them be lanced. Also give a mild pur- 
gative every day or two until well. A teaspoonful of syrup 
of rhubarb, or castor oil, will answer. 

Colds and Snuffles. — During the first month, most children 
ftre affected with colds, commonly in the nose, called snuffles. 
Warming the feet at the fire, will often be sufficient to cure 
them. " But when the disease is attended with fever, it is best 
to administer three grains of ipecac, mixed in four table spoon- 
fuls of warm water, and one table spoonful to be given every 
twenty minutes, until vomiting is produced. The bowela 
Should be kept open with magnesia, rhubarb, manna, or castoi 
oil, in small doses. Repeat the ipecac next day if the disease 
is not better. 

Various Eruptions of the Skin. — Children, particularly 
those not daily bathed, or washed in water, are very subject 
to a great variety of eruptions on their skin, commencing some- 
times the first week of their birth. Different names, as res 
gum and white gum are given to each kind ; but it is useless 



Eruptions of the Shin — Sore Eyes. 129 

as tliey require nearly the same treatment. In the red gum 
there is a number of small, elevated red spots, scattered ovei 
tne body, and sometimes on the cheek or forehead ; on the 
feet the spots are still larger, and contain occasionally a clear 
fluid. In some stages it resembles the measles. Generally no 
medicine is requisite ; but if it suddenly disappears, and the child 
shows symptoms of internal disease, an emetic of ipecac, as men- 
tioned under head of Snuffles, or purgative ought to be given, 
and repeated, if not at first relieved. The white gum appears 
after the red gum, resembling itch, with white, shining little blis- 
ters, containing a little clear fluid. There are other varieties of 
these eruptions of the skin, but few of them require medical treat 
ment. A vomit or purge, to clear the stomach and bowels 
generally relieves. The prevention is in great cleanliness, free 
washing daily in soap and water, with regularity in nursing. 
When these affections of the skin are attended with fever, they 
require, besides the vomit and purging, applications to the 
parts inflamed, to lessen the action ; cold lead water (two or 
three grains of sugar of lead dissolved in one ounce of eold 
water), and sweet oil, are the best for this purpose applied 
svery three hours. 

Sore Eyes. — Children are very subject, sometimes during 
the first month, to inflammation of their eyelids and eyes, par- 
ticularly those who are exposed to a strong light soon after 
birth, getting soap in the eyes by the nurse when washing 
them, perhaps for the first time, a draft of cold air, etc. At 
whatever time the inflammation comes on, in slight cases, a 
rery weak solution of sugar of lead — fifteen grains to the pint 
of water, should be applied every two hours to the part, by 
Cleans of a piece of linen soaked in the water and laid over the 
b< re eyes for a few minutes at a time. In many cases the 
warm breast-milk of the mother put into the child's eyes every 
v'me that it nurses, will cure them. (In cases where much thick 
matter is discharged from the eyes, or they are closed up, and 
the eyelids puffed out, a physician should be sent for at once, for 
the eyesight may be lost in a few hours, if not properly attended 
to.) If it do not speedily subside, a purge of castor oil should 
be given. The inflamed eyes should never be turned towards 
the fire, and the hand of the infant so confined as to prevent 
\i from rubbing the part, and the room kept darkened. In 
cases where the inflammation of the ball of the eye is great, a 
leech should be applied to each temple, or cupped, after being 
scarified. Also five to ten drop** of syrup of ipecac should bt 
given every two hours k> reduce inflammation. 

This cold lead water alone is usually the proper application 



130 Wind in the Stomach and Bowels. 

to the eye, and nothing should be added excepting where tha 
eyelids adhere together. In this case, the mildest sweet oil, 
mild hog's lard, or any bland grease should be applied to the 
edges of the eyelids before the child goes to sleep. Avoid 
every stimulating application in inflammations of the eyes ; it 
has been the cause frequently of loss of vision. 

Excoriation. — When the skin is rubbed oif (termed excori- 
ation*, as is often the case between the legs, behind the ears, 
in the hair, between the toes or fingers, etc., you should make 
an application of sugar of lead (twenty grains dissolved In a 
pint of cold water) three or four times a day, with a soft linen 
cloth, or sweet oil, or fresh lard, will generally heal them up, 
Powdered starch is also good. 

In cases of inflammation, a poultice of Indian corn meal or 
flax-seed meal wet with this lead water, and kept applied to the 
part, will expedite the cure. When sores have been of long 
standing, you should, by all means, on drying them up, purge 
the child once or twice a week, for three or four weeks after- 
wards ; also diminish its food. The neglect to do this, or to 
make a slight issue or sore, by means of a small blister plaster, 
applied and kept to some part of the body, two or three hours 
every day, for a week or two, has often been fatal ; as the 
system, when the old sores are healed, not having its accus- 
tomed irritation, takes on violent disease in other parts. Death 
has often resulted from healing up old sores suddenly, without 
taking the precaution alluded to. 

WIND IN THE STOMACH AND BOWELS. 

When a child has wind on the stomach it may be known by 
wind often rising in its throat, which makes it struggle at 
times, as if to get its breath, and from which it is occasionally 
relieved by belching of wind upwards. When it often occuri 
it is annoying, and interrupts rest. It is most common with 
children dry-nursed. 

Different articles have been given to dispel the wind ; but 
aone of them are to be compared to spirit of hartshorn: three 
drops in half a table spoonful of cold water, and repeated two 
or three times a day, as may be required. Hartshorn, when 
it will answer the purpose, is to be preferred to cordials, spirits, 
seeds, spices, and hot things of any kind ; as, although it is 
fully as powerful in dispelling the wind as any of them, it will 
not, by a permanent heat, nor by repetition, injure the stomaeJi 
as they do ; nor can any bad habit or other disadvantage arise 
from giving and repeating it as often and long as it may bts 
necessary. It is endowed with a property which makes it » 



Diarrhoea or .Looseness of the Bowels. 131 

desirable medicine for children ; it corrects and removes acid- 
ity or sourness, a principal cause of griping with children. 
The dose here mentioned is the smallest that need ever ba 
given, and it may be increased, as a child grows older, to five 
or six drops. The child's bowels should be kept open with 
mild purgatives, such as magnesia, syrup of rhubarb, etc. 
Also be careful that nothing in the way of nourishment be 
taken except the breast-milk, until the disease is entirely 
tured. If the hartshorn can not be had, use a tea made oi 
aniseed, catnip, mint, or cinnamon bark, (not too strong) every 
half hour. 

Some children seem naturally more subject to wind in their 
bowels than others ; and which can be accounted for no other- 
wise, than as proceeding from a particular weak and tender 
etate of those parts. And as it is much increased by cold, a 
particular attention must be paid to keeping them well covered 
with flannel next the skin, and three or lour times a day use 
friction or rubbing with the dry hand over the stomach and 
bowels. 

DIAURHCEA OB LOOSENESS OF THE BOWELS. 

This is generally brought on by too much, or unsuitable 
food ; in which case great attention should be paid to the 
diet. In other cases, it may arise from disease of the 
bowels, such as irritation from worms, or inflammation. In 
such cases a dose of ipecac, according to the age, should be 
given to produce vomiting, so as to get the stomach emptied 
af its contents, (unless there is already sickness at the stom- 
a ?h ;) then the bowels are to be cleansed by a purge of a 
little rhubarb and magnesia; (four grains of each,) to be fol- 
lowed by small doses of chalk in some mucilage, as milk — 
made more palatable by a drop or two of the essence of pep- 
permint, cinnamon or aniseed. Flannel, soaked in whisky, 
should be applied to the bowels, and the child made to lie 
down in bed and keep as quiet as possible. If the stools con- 
tinue more frequent than they ought to be, and are either 
slimy or tinged with blood, the purge of rhubarb and magne- 
sia should be repeated. Cold drinks of all kinds should be 
allowed only in very small quantities at a time : small pieces 
ji ice taken into the mouth and allowed to melt, is better for 
allaying thirst. Sponging the body also once or twice a day, 
jrith a mixture of water and whisky, is often of signal benefit. 
The diet must be of the simplest kind, avoiding all kinds of 
solid food. Warm applications are to be made to the bowels, 
and the skin gently rubbed. Sometimes the application of a 



132 Falling of the Fundament — Colic. 

smalt Mister to the pit of the stomach is of great service. -A 
mustard plaster applied for a few minutes at a time to the 
stomach and bowels, two or three times a day, is often of great 
service, and is always to be tried in preference to the blister, 
especially in small children. In cases where the strength ia 
fast sinking, injections of thin starch, with a few drops of laud 
anum or paregoric, with a teasponful of wine or whisky 
every two or three hours, should be given ; and laudanum maj 
be rubbed on the stomach and bowels, with sweet oil. 

Falling of the Fundament.— In children of lax habits, th? 
lower portion of the bowel is very apt to protrude after a sttol 
It is a source sometimes of great pain, and often of great un- 
easiness, jn general it may be replaced by the application of 
a rag wet with cold water, using very moderate compression. 
More obstinate cases require that the child should be laid on 
its belly, the sides separated, and then the fingers of the hand 
are to be applied, so as equally to cover the protruded part ; 
then gradually and firmly, in one continued pressure, the part 
may be caused to draw up. Whenever the bowel protruded i? 
inflamed or painful, it should be bathed in cool water, cold 
green tea, olive oil, or hog's lard. Sometimes fomentations of 
mild articles, as flax-seed poultice, hops, with hot water, &c, 
are of service. 

Those children much subject to this complaint, should never 
be allowed to strain in evacuating the bowels. The discharge 
had best be made in an erect posture. The strength of the 
bowel may be restored by injections of tea madu of oak bark or 
nut galls : when the irritation is great, a drop or two of lauda- 
num will lessen it. Pouring cold water occasionally on the 
parts, and always alter a discharge washing in cold water will 
be found serviceable. 

Colic. — Colic, which in some children is of Miry common 
occurrence, is easily discovered by sudden fits of crying or 
screaming, which nothing can appease ; the child bends back 
the body, spurs with the feet, and then has an abatement of 
the pain for a few minutes, obtained sometimes by the escape 
of wind from the stomach or bowels. An attack may consist 
of one uninterrupted lit, or of repeated screaming, with inter- 
vening moments of ease. It may be induced by costiveness, 
by cold, by damp clothes, by the too liberal use of panada, 
particularly if made of sour bread ; by passion, or some state 
of the nurse affecting the milk, by collection of wind in the 
bowels ; or it may accompany thin and slimy purging, which 
is sometimes produced by the injudicious use of purges. 

In ordinary cases, nurses give gin and water 3 whieb i» » 



Spasms or Convulsions. 133 

most injurious practice, and may in some instances kill th« 
child. Laudanum gives speedy relief, but it weakens the 
stomach and nervous system, and produces costiveness. A 
few drons of tincture of asafoetida, mixed with oil of anise, is 
generally effectual, and is always safe. Two drachms of tinc- 
ture of asafoetida, twenty drops of oil of anise, and an ounce 
of mucilage of gum arabic, may be rubbed up together : and 
if this mixture, from ten to twenty drops, in a little water, will 
be a proper dose, as often as occasion may require. The warm 
Bath is useful, and if these means do not give relief, rubbing 
the stomach and bowels with laudanum will be safer than 
giving it internally. An injection of gruel and a little oil is 
proper, and cloths dipped in hot water and applied to the bow- 
els is also good ; and if the child has been costive, it will be 
right to give a tea spoonful of castor oil, after these remedies 
have relieved, in order to prevent a return. 

When children are subject to colic, we may suspect that 
there is something wrong in the diet. Common panado, espe- 
cially if it contain much sugar, is very apt to have this effect. 
The nurse's milk may also be flatulent, and this bad property 
is sometimes increased by the use of porter or ale, intended to 
increase the quantity. The state of the child's bowels must be 
attended to, and it should not be allowed to load the stomach 
by taking too much at a time. If it belches up wind after 
eucking, it should be gently dandled, as that promotes expul- 
sion. 

SPASMS OR CONVULSIONS. 

This unpleasant and often dangerous disease may take place 
at any age, and may occur either in the course of some other 
disease, under which the child has been laboring for some 
time, or suddenly, in apparent good health. In one case they 
are highly dangerous, and often indicate a fatal result ; in the 
other, they are frequently attended with little hazard. Con- 
rulsions vary in degree, from a slight movement of the muscles 
of the face, to a rigid, or convulsed state of almost the whole 
body. In general, whatever be the degree of the movement, 
the countenance is altered, both in color and expression : the 
patient is insensible, and cannot follow an object with the eye 
In some instances, the motion is so slight, that the child may 
rather be said to be in a state of fainting, or stupor, than ot 
convulsion. In very young infants, there is sometimes onlv a 
smile about the mouth ; the eye, which is half closed, turns 
slowly round, the breathing seems occasionally to flutter, and 
the child starts, and throws out the arms on the least noise. 



134 Spasms or Convulsions. 

These motions, called inward fits, frequently proceed from 
wind in the bowels. 

Convulsions sometimes go off in a few seconds ; in othei 
instances they continue for several minutes. The child may 
have only one short attack, and become well immediately 
afterwards, or it may remain in a languid, sleepy state; or i! 
may have repeated attacks in a very short time, and continue 
insensible during the whole of the intervening period, which 
>s always an unfavorable symptom. They may be produced by 
wind, or irritation in the bowels, dependent on worms, cos 
tiveness, indigestible food, griping, stools, &c. ; or by teething ; 
or by breathing bad or confined air ; or by the striking in of 
some eruption ; or during the coming out of others, such aa 
small-pox ; or by affections of the brain itself; or by othe* 
spasmodic diseases, such as hooping-cough, &c. 

When the child has been ill for some time before convul- 
sions come on, especially if the pulse has been quick, the 
skin warm, and the head affected, whilst these symptoms could 
not be traced to the effect of teething, there is ground to be- 
lieve that the convulsions proceed from a diseased state of the 
brain. 

With very young infants, if there have been no preceding 
disease, there is great reason to attribute the convulsion to the 
state of the bowels : and we shall be confirmed in our opinion 
by finding that the stools are not of a good appearance : that 
there is much wind in the bowels ; that the child has not been 
nursed or fed properly ; that the nurse has been agitated by 
passion, or committed some irregularity in diet ; or lastly, in 
infants a few days old, that the meconium (or contents of the 
bowels,) is not expelled. 

When young infants have convulsions from the state of the 

bowels, we generally find that the face is pale and the motions 

slight ; but if they proceed from the state of the brain, which 

; s still more alarming, the motions are stronger, and more de- 

erving of the name of convulsion. 

After the child is two months old, irritation of the boweK 
proceeding from bad stools, worms, or indigestible food, does 
not produce those gentle motions, or that apparently languid 
state, observable at an earlier period, but generally excites 
pretty strong and well marked convulsions. 

At the period when children are teething, convulsions may 
be produced by irritation of the gums, more likely than by 
other causes ; and, therefore, we should in every case whiel 
oeours at that time, examine the gums carefully and cut then 
If there be the slightest swelling or sign of teething. 



Sore Head. 135 

When a child is seized with convulsions, great consternation 
immediately prevails, and without some common sense rules, 
either nothing will be done, or very contradictory plans may be 
adopted. 

The first general rule in such cases is, if the child seems to 
be sick, or oppressed in its breathing, or has a fulness of the 
stomach, or has been known to have had something which has 
disordered the stomach, vomiting should be excited, by tick- 
ling the throat with a feather, during the fit, or by giving 
ipecac, (five to ten grains, in warm water, or one or two tea- 
spoonsful of the syrup,) as soon as the child can swallow. Rub- 
bing the spine, or along the back- bone, with some stimulating 
liniment, or a mixture of one tea spoonful of ground mustard, 
one of salt, one gill of vinegar, and half pint of water, with a 
little laudanum, will be beneficial. Cold water and vinegar 
mixed in equal parts, in which a cloth has been soaked, and 
applied to the head, is also good in cases where there is flush* 
ed face, fever, and insensibility between the convulsions. At 
tke same time, give injections of warm soap-suds, or warm 
water and castor oil up the bowels, and as soon as the child 
can swallow, give a good brisk purge of castor oil, Rochelie 
salts, (one table spoonful in water,) or rhubard and magnesia. 
Rubbing chloroform on the temples and back-bone is also 
some times beneficial in severe cases, as also is pounded ice, 
wrapped 'n a bladder or piece of cloth, and applied to the 
head. 

When there is a tendency to frequent returns, it will be 
proper, besides keeping the bowels open, to give repeatedly a 
tew drops of tincture of asafoetida, mixed with oil of anise. In 
all cases of weakness, the strength is to be supported by suit- 
able nourishment, even by injections of beef tea. 

SOME HEAD. 

Some children, are subject to sore head. It often be- 
gins on the fore part of the head, in large white scabs, 
which, if neglected, spread over the head, forehead and face, 
in large patches. In the beginning, generally, it is dry ; 
at other times, it is moist and has a thin discharge. Medical 
writers have named this complaint cricsta lactea, or milky 
crust, from its appearance. The children of the lower order 
of country persons, who are gross in feeding, are most subject 
to it ; and it seems to be occasioned by a want of cleanliness 
and exercise, which children, who have a bountiful supply ot 
nourishment, require ; but to which parents, in this situation, 
are not often disposed, or seldomer have opportunity to afford 



136 Scald Head — Measles. 

them. A cabbage leaf s a very common application, as il 
promotes a discharge from the head, which is supposed neces- 
sary, previous to the cure ; but as such a discharge is in no 
way necessary, and as it makes the head uncommonly ofFen 
give, it is better not to encourage it, and the sooner the com 
plaint is cured the better. For that purpose, take of brandy 
(or whisky) and water, each equal parts ; mix them together, 
and bathe the parts of the head and face where the complain! 
is, once a day, and immediately afterwards lay on a plaster of 
basilicon ointment, (made of lard, eight ounces ; resin, five 
ounces ; yellow wax, two ounces ; melted together,) spread 
upon a linen rag, which is also to be renewed every day, after 
each washing with the brandy and water. Two or three doses 
of purgative medicine must be given during the cure. Bath 
ing in the sea, or salt and water, will be of great use. 

SCALD HEAD. 

This is different from the preceding, as the soreness it 
confined altogether to the head, but will extend to the 
neck if neglected. It begins in distinct brownish spots, 
that form a scab and discharge a thick, gluey matter, that 
Sticks amongst the hair. The spots increase and enlarge so as 
to cover a great part of the head. When these spots are dis- 
covered, the hair upon and about them must be cut as close aa 
possible, and they must be washed well, every day once or 
twice, with soap and water. Should that not prove sufficient 
to remove them, they may be daily anointed with a little tar 
ointment, (a mixture of tar and fresh lard, in equal propor- 
tions 3 ) or Barbadoes tar mixed with sweet oil, in equal pro- 
portions, with the point of the finger, which rarely fails of a 
cure. The scald head, which is either this complaint in the 
extreme or nearly allied to it, may be treated in the same 
manner, and which will be going as far as can with propriety 
be attempted before consulting a physician. 

MEASLES. 

The symptoms of the measles are, a sickness, a heaviness, a 
thirst, a short, dry, husky cough, with hoarseness, a sneezing, 
a running at the nose, and a running and thin discharge from 
the eyes, which appear red and much inflamed, particularly 
the eyelids, with sometimes cold shiverings. These symptoms 
are commonly slight at first, and increase till the measles corns 
out, which generally happens on t^e fourth day from the first 
attack, although children will frequently be much indisposed 
for a week before they come out. At the first appearance of 



Measles. 137 

lilt? measles, they look like flea bites upon the face and neck, 
in distant spots ; but soon after, the face, neck and breast are 
covered in patches, resembling a thick rash, that does not seem 
to rise above the skin, although it may be discovered by the 
touch and feel of the hand, to be a little prominent or raised 
upon the face and breast, but not upon the other parts of the 
body. The measles, like the small-pox, come out first upon 
the upper part of the body, and last of all upon the feet ; and 
they observe the same progressive regularity in going off. 

This disease is attended with much depression and dejec- 
tion^ and sickness at the stomach. It is very common for the 
most lively children to lie in a stupor, or state of heaviness 
and seeming insensibility, from the second day of the attack, 
during the whole of the complaint, which continues three 
days after the first coming out ; on the third day the eruption 
begins to look paler, and, on the fourth, goes off with a mealy 
appearance upon the skin. During the whole of the com- 
plaint there is considerable fever, which often, with the cough 
and a difficulty of breathing, increases in proportion as the 
disorder advances, and will sometimes be the most violent and 
severe at the height, or turn, of the measles ; sometimes the 
fever, cough, and other symptoms abate, and the child re- 
covers, in part, his spirits soon after the measles come out, but 
not generally. 

The patient must not be kept either very warm or very 
cold ; he ought not to be kept near the fire, nor yet suffered to 
breathe the cold air ; it will be best to confine him to one 
room that is moderately and temperately warm. Cold air will 
add to his hoarseness, and make the cough worse. His drink 
may be water, barley water, milk and water, balm tea, saffron 
tea, or anything of the kind ; but water, or milk and water, 
seems most agreeable to children at this time. What he 
drinks ought to be a little warmed, but not hot. Wine, cor 
dials, and all stimulating drinks are improper and injurious. 

These precautions are always to be observed on the first at- 
tack of the measles. It will always be proper to give some- 
thing at the beginning, to procure two or three loose stools, as 
the infusion of senna, salts, castor oil, prunes, or manna, &c. 

Mustard plasters, applied between the shoulders or to the 
sides, have been found of great use in abating the cough an 
relieving *:he breathing, and may safely be applied at anj 
period of the disease, if the cough and breathing be bad 
Cupping the sides and back is also of value. 

A fever always accompanies the measles, and is the cause 
»f the drowsiness and stupor which children have in the be- 



138 Measles. 

ginning, and often during the whole of the complaint. Noih. 
mg wiu so sensibly check and abate this fever, remove thi 
drowsiness, and restore a child's spirits, as repeated doses of 
ipecac and spirits nitre. Mix five grains of powdered ipecac, 
(or one tablespoonful of the syrup,) and one tablespoonful of 
spirits nitre, and two ounces of cold water, together. Of thii 
give one teaspoonful every three or four hours, unless there is 
much sickness at the stomach. It may be begun with on 
the second or third day ; and after the stools have been pro- 
cured, as above directed, while the fever and heaviness con- 
tinue, it will be particularly proper to give it in the evening, at 
which time the fever is most severe, and if it operates, as it 
generally does, both by vomit and stool, it will give most 
sensible relief — the fever, heat, and oppression will be con- 
siderably abated, and the child will be much more easy and 
cheerful, and more tranquil and composed, than befo; e 
taking it. 

The fever and cougn will frequently continue, without much 
abatement, for a few days, or a week, after the measles aie 
entirely gone, but which may be greatly relieved, or entirely 
removed, by giving a gentle purgative every second day. Lt 
may also be known that the fever continues while the dullness, 
thirst, and want of appetite remain, and during which time 
the purgatives ought to be given, at proper intervals, if no 
other cause forbids it. It may also as certainly be known that 
the fever is gone off when the child's spirits and appetite re- 
turn. The danger from the measles is much increased when 
they happen to be connected with the small-pox or hooping- 
cough ; and, therefore, so circumstanced, they require mora 
medical attention than is generally bestowed upon them. 

The eyes, and particularly the eye-lids, will sometimes re- 
main sore, swelled, and inflamed after the m easels. The cough 
also, will oftentimes continue for sometime after the fever and 
every other remains of the measels are gone. While either 
the sore eyes, or the cough remain, the child ought not to be 
Buffered to go out of doors, or to be exposed to the cold ; as 
the air, in cold weather particularly, is very apt to add to and 
greatly aggravate these complaints, and may make them very 
troublesome and tedious. Too much caution, therefore, in 
avoiding cold, cannot be observed during the disease or while 
there are any remains of sore eyes, or cough. The measeli 
sometimes leave these symptoms for the remainder of life~~ 
which most frequently may be attributed to a too early ventur- 
ing out, which of course would have been prevented fcj feet 
wkaible conjmement within doors. 



Warms. 139 

WORMS 

When a child gets sick, and the mother can find no othei 
^jiution of the difficulty, she is almost sure to attribute it to 
worms. She is often er wrong than right. Worms of dif- 
ferent kinds are often found in the bowels ; but there are 
chiefly two met with in children, the lumbricus, or long worm, 
having a great resemblance to the common earth worm, and 
the ascaris, or small white worm, like a bit of thread. These 
two kinds inhabit different parts of the bowels, the small 
worms being confined to the lower part, whilst the other is 
found much higher. It is extremely difficult to account for 
the production of worms. It is observable, that few infants* 
have worms till after they are weaned, which is to be account- 
ed for on the principle that the bowels are in better ordei 
during suckling than afterwards, when the diet is more varied 
and indigestible. 

Worms may exist without producing any symptoms, until 
they either accumulate in considerable quantity, when they 
cause more or less irritation in the bowels, or some slight in- 
disposition takes place, and they, by their irritation, increase 
it. All the injury they produce, is that of irritation : but the 
degree of this, and the effects of it, must vary, not merely ac- 
cording to the number of worms, and their movements, but also 
according to the state of the bowels themselves. It is also to 
be remembered, that as a weakened state of the bowels is fa- 
forable for the accumulation of worms, many of the symptoms 
may proceed from that state alone, independent of the new 
irritation from worms. 

The long worms may be suspected to exist, when the child 
complains of frequent griping or pain in the belly, has repeat- 
ed and unexpected attacks of looseness, variable appetite, be- 
ing sometimes seized suddenly with extreme hunger, haa 
dwelling of the belly, especially at night, disturbed sleep, 
frightful dreams, and grinding of the teeth. Always give chil- 
dren something to eat at once when they thus cry out with 
hunger. A failure to do this has caused the worms to pierce 
the bowels through, and cause death , when a slice of bread and 
butter would have saved its life. Besides these symptoms, we 
also observe that the countenanceis.alternately pale smdjlxsk' 
«tf; the child picks its nose, has bad breath, dry cough, and 
sometimes slow /ever, or convulsive affections. These symo- 
toms may exist in different degrees, and are ultimately attend- 
ed with the expulsion of worms, either by vomiting or s;ooL 
It has been supposed that a very obstinate and protracted fe- 
ver, called "worm fever" might also be produced: but thia 



140 Hooping Cough. 

generally depends more upon costiveness, or a deranged state 
of the bowels, than simply upon worms. It resembles a most 
formidable disease, " water on the brain." 

A variety of worm medicines have been employed, such as 
tin powder, tansey, sulphur, hellebore, worm seed, cowage, In- 
dian pink root, &c, besides the thousand and one nostrums 
gold by druggists. In general, however, we find that with 
children, the most successful plan is to give frequent and re- 
peated purgatives, to expel both the worms and morbid stools^ 
and also to excite and support the due and vigorous action of 
the bowels. Castor oil, in tea spoonful doses, in which a few 
drops of oil of lemon are put, given about three times a week, 
is better than all the nostrums you can buy. The extent to 
which this plan is to be carried, and the period for which it 
must be continued, will depend upon the effects produced. 
As long as the stools are unnatural, the purging should be con 
tinued. 

In cases of a third species of worms, called tsenia, or tape 
worm, it is sometimes difficult to cause the expulsion. It ia 
most common to adults. Large doses of the spirit of turpen 
tine have been recommended, (taken in milk.) on an empty 
stomach in the morning. The dose to be from two to three 
table spoonfuls for a robust grown person. 

An infusion of tobacco, applied to the stomach, has often 
caused the expulsion of worms, when other remedies failed.-— 
But I never knew a case of failure when the patient was freely 
purged with calomel, and then given either the worm-seed oil, 
or the pink root in tea. The oil should be given on an empty 
stomach in the morning, (ten to twenty drops,) or the tea ot 
pink root taken occasionally throughout the day, in doses to 
suit the age of the patient. About ten grains of the powder 
may be given to a child of eight or ten years old, two or three 
times a day. When in over doses, it is apt to affect the 1 tead, 
and the quantity is to be lessened. 

The generation of worms may be prevented by whatever 
will strengthen the bowels. A good, healthy diet, exercise in 
the open air, and an infus on of tea made from Peruvian barks> 
(a wine glass before each meal) are advisable. 

HOOPING COUGH. 

This disease is generally treated improperly by parenta. 
In the beginning it is always an inflammatory complaint, re» 
quiring evacuations and determination of blood to the surface 
of the body, by giving warm teas or ipecac in small dose* 
every two hours to produce sweating. Instead of the variety 



Costiveness, 141 

of prescriptions in daily use, give the child an emetic (or vomit), 
of ipecac in the usual dose, to be repeated every day or othef 
day for four or five days, unless the symptoms lessen. For a 
violent fit of coughing, the best remedy is, to pour in the back 
of the mouth a teaspoonful of melted hog's lard or sweet oil, 
which sheathes the part, and lessens the irritation. The tinc- 
ture of asafcetida, twenty to thirty drops every four hours, is 
highly recommended. A child grown enough for the purpose, 
will find some relief in holding warm water in the back of the 
throat. It is of great importance to children in this complaint, 
fco keep the skin in good condition. A coarse flannel shirt 
around the breast, has been of great service by keeping up 
friction on the surface. With the flesh brush or a ball of wool, 
the surface of the body should be rubbed every night. Exer- 
cise in the open air, while the body is kept comfortable, is ad- 
visable, as well as change of residence for a few weeks, which 
scarcely ever fails to afford relief. The juice of garlic sweet- 
ened, lessens the cough. A solution of soda, also of alum, in 
doses of three or four grains, and sweetened with liquorice, 
given night and morning, is a valuable remedy. A mixture 
of twenty grains of tartar emetic and an ounce of tincture of 
Spanish flies, nightly rubbed on the stomach, is a remedy 
highly extolled. 

COSTIVENESS. 

This complaint is sometimes hereditary, or natural to 
the child ; when this is the case, and it does not exceed 
proper bounds, it may not require the use of any remedy; 
but should the infant's health begin to suffer from frequent 
attacks of colic, flatulence, etc., it should be attended to, as it 
may produce convulsions or fits, inflammation of the bowels, 
or other diseases of a difficult and lingering nature, or establish 
a costive habit for life. 

If the predisposition has descended from the mother of the 
same habit, or in other words, if the mother herself is subject 
to costiveness, the child may be relieved for a short time, but 
't will again return. When this is the case, the mother, if pos- 
sible, shou-d change the quality of the milk, by being atten- 
tive to her diet, and take occasionally some mild purgative, 
which will alter the quality of her milk ; for this purpose there 
Ls no medicine superior, or more innocent than magnesia and 
Epsom salts, of equal quantities, mixed and ground very fina 
in a mortar. Of this, take a teaspoonful or two in a tumbler 
of water every morning on an empty stomach. When the cos* 
tiveness originates from the child's food, it must be changed 



142 Diseases of the Ear. 

and simple medicines given occasionally, to act as a mild purg^ 
such as five or ten grains of magnesia, rhubarb or manna, a tea 
spoonful of sweet oil, or castor oil. But the best plan in such 
cases is to allow the mother, if the child is nursing, or the child 
itself if it has been weaned, a plentiful supply of syrup, mo- 
lasses, and stewed fruit, at meals, and ripe fruit uncooked, be- 
tween meals, and teaching the child to go to stool at regular 
hours. Children often have a disposition to go to stool hutpui 
it off till the effort of nature passes. The mother should be 
attentive in these matters if she wants her children to b« 
healthy in body, happy in mind, and sound sleepers at night 

DISEASES OF THE E A II . 

Acute inflammation of the ear is known by the swelling, 
acute pain and noise in the head, and pain in swallowing 
or moving the lower jaw. Chronic inflammation is at 
tended by some degree of deafness and discharge of mas- 
ter. The disease is caused by colds, foreign bodies in the 
ear, measles, scarlet fever and scrofula. Nervous earache oc- 
curs in paroxysms of severe pain in the ear, and shooting ovor 
the face, head, neck and shoulder. It is caused by sudden 
cold, decayed teeth, and sometimes by fullness of blood. The 
warm foot bath, with some ground mustard and salt in the 
water, and hot applications to the ear and face, usually grse 
relief. A drop or two, each, of laudanum and sweet oil put 
into the ear on a piece of warm wool, is an old and valuable 
remedy, to be repeated every hour or two if necessary. Hold- 
ing hot coffee or tea in the mouth is also good, or gargling the 
throat well with tea or coffee, and then spirting the liquid out 
through the nose by stooping forward with the mouth closed. 
A bag of hops steamed over boiling water, then allowed to 
cool sufficiently to be agreeable, and applied to the ear, often 
affords relief in a short time. If an insect is in the ear pour 
warm sweet oil into it ; this will generally cause it to come out 
to get air. Foreign bodies* such as beans, coffee, dust, etc., 
sometimes get into the ear and cause intense pain : they may 
be removed by syringing the ear with water, or by a smal] 
probe or blount wire, doubled, or bent into the proper shape. 
Great care must be exercised not to hurt the drum of the ear. 

Running from the Ears.— When the discharge after an 
abscess does not disappear, or when running from the ears 
shows itself after acute diseases, such as measles, scarlet fever, 
etc., the symptom must not be neglected, and should be ex- 
amined into by a medical man. It is most common in chil- 
dren of a weak or scrofulous constitution, and may be with oi 



Malignant Sore Throat. 143 

mthout disease of the bone ; in the latter case the discharge is 
extremely offensive, and often stains the linen black. These 
discharges must not be too quickly stopped, neither can they 
oe allowed to go on without risk ; in the former case, the sud- 
den stoppage may throw back the disease upon the brain ; in 
the latter, this organ or its membranes may become affected 
by its gradual extension to them through the bones. Counter- 
irritation, by blisters, or tartar emetic ointment, (ten grains of 
the powder to one teaspoonful of lard, well mixed, and applied 
once a day till little pimples appear) behind the ears ; keep 
the bowels open regularly. The general tonic treatment as re- 
commended in some other diseases of children already treated 
of, and syringing with slightly astringent washes, such as one 
grain of lunar caustic, or two of white vitriol, to the ounce of 
water, or a wash of strong green tea will constitute the most 
appropriate treatment. 

M ALIGN ANT SORE THROAT. 

This species of sore throat differs from that which at- 
tends malignant scarlet fever. It is usually limited to the 
upper part of the throat. It begins with redness, swell- 
ing of the tonsils, bloated face, flow of tears, chills and 
flashes of fever : the redness of the throat soon changes to a 
dull ash color, and then to brown or black — there is thirst, 
hoarseness, difficulty in swallowing, nausea, sometimes vomit- 
ing and diarrhoea. In the more severe cases there is a bloody 
or watery discharge from the nose, and an offensive discharge 
from the throat — the tongue becomes brown, dry, and coated, 
there is often an eruption on the skin, sinking of the powers 
oflife, and finally death in severe cases. 

Most medical writers consider this disease contagious — it is 
caused also by cold, wet, insufficient clothing and food, bad 
air, and want of personal neatness : it is a very dangerous dis- 
ease, and requires prompt and efficient treatment. A phy- 
sician should be immediately called in ; in the meantime, or 
in cases where one can not be had, give the patient an emetic 
of ipecac ; then give a purgative of one teaspoonful or two of 
Rochelle salts, in half a gill of luke-warm water. Apply a 
mustard plaster to the throat, and give every hour or two a 
gargle of sweet oil or melted lard, mixed with a few drops of 
spirits camphor and a little sulphate of iron (green vitriol) dis 
solved in water. 

A gargle made of Cayenne pepper and oak bark tea, not too 
strong, with a little salt in it, is also good. Also a gargle 
made of yeast and finely powdered charcoal has been used 



14:4 Choking — Cholera Infantum. 

with great benefit. "When the patient is weak the strength 
must be supported by tonics, such as wine and infusion (or tea) 
of Peruvian barks, or one grain of quinine, three times a day 
Where there is a feeling of suffocation or choking, it is advis* 
able to produce vomiting, either by tickling the throat with a 
feather, or giving a dose of ipecac, to clear the throat. 

CHOKING. 

Children sometimes get choked by bits of food or stones of 
fruit, which produce cough, blueness of the face, gagging, 
sometimes nose-bleed and convulsions — and if relief is not 
given, death ensues. 

When a child is choked, he should he held with the head 
downwards and receive two or three smart blows on the back 
between the shoulders : if this does not give relief, the mouth 
should be thrown wide open, and some person should endeavor 
to dislodge the substance, either bringing it out of the mouth 
or gently pushing it downwards ; a few swallows of water may 
enable it to pass into the stomach. 

CHOLERA INFANTUM. (Summer Complaint.) 

This is one of the most fatal diseases to which the period of 
infancy is subject : it occurs mostly among children under the 
age of two years, and during the warmer part of the season. 
This is said by authors to be a disease peculiar to the United 
States. 

It usually commences with a profuse discharge from th# 
bowels of a light-colored fluid ; after a short time the extreme 
irritability of the stomach is manifested by the constant vomit- 
ing of everything swallowed. The discharges from the bowels 
sometimes contain flakes of mucus : the passages are often 
involuntary, and attended by much irritability and debility : 
the tongue is coated with a white slimy matter, the skin dry, 
pulse quick and small, much thirst, bowels hot, sometimes 
bloated and tender : there is, at times, moaning or sudden 
gcreeching, indicating acute pain. 

Digestion is so far suspended that whatever is eaten passes 
unchanged. In some cases delirium comes on early, and the 
little sufferer dies in one or two days from the attack : at other 
times the disease continues until extreme emaciation is pro- 
duced ; the skin has a wrinkled, dirty appearance, bathed in 
cold perspiration, the features sharp, eyes large and glaring, 
the whole countenance has the appearance of old age. Tha 
cholera of infants is mostly a disease of the mucus coat and 
glands of the bowels —often accompanied by enlargement o\ 



Dysentery. 145 

the lirei . It is caused by impure, stagnant, or confined air, 
coming in contact with the sensitive surface of the air passage*, 
akin and digestive organs, and improper food. 

The disease may he produced by all the causes which pro 
4uce diarrhoea : it seems mostly to prevail in low, damp situ- 
ations, in towns and cities. ' Perfect cleanliness, pure air, good 
diet, and change of location when it depends on that, are in- 
dispensable in addition to medical skill. 

When the child can not be taken to the country, take it 
*ften into the open air, in the cool of the day in good weather 
It should be confined entirely to the breast-milk when nursing 
or if weaned, let its food be arrow-root, tapioca, corn starch 
rice flour, and milk. Put it in the warm bath once a day ; 
keep flannel next the skin, and the bowels moistened out- 
wardly frequently by vinegar and water, and the arms, hands, 
feet and legs, frequently rubbed with whisky or any kind of 
spirits. Give small pieces of ice to melt in the mouth in pre- 
ference to water. For the vomiting, give a few Srops of es- 
sence of peppermint in water frequently, or essence of cinna- 
mon, or a tea made of allspice (cold), in which there is a little 
gum arabic and a teaspoonful or two of prepared chalk to the 
cupful of tea. Of this give a teaspoonful every hour. Acidity 
or sourness of the stomach seems to be the great difficulty in 
this disease, and, as a consequence, suddenly checking the 
bowels will not do until the preparation of chalk has to some 
extent corrected this sourness. If the discharges become very 
oifensive, a mixture of charcoal, finely powdered, with chalk 
and white sugar, equal parts, and thick mucilage of gum ara- 
bic given three or four times a day will be advisable. 

Mucilage of gum arabic or thick slippery elm water, made 
by putting the slippery elm in cold water, to which add one 
teaspoonful of spirits of nitre to the half pint, given in tea- 
spoonful doses, is also a good remedy. Sometimes nothing 
will afford relief as quick as one half grain of calomel given 
every four hours, and continued until the passages are more 
natural. 

D TSENTEJRT. 

This disease consists of inflammation, which is confined 
mostly tc the large bowels. In some cases, however, the in 
fUmmation extends to the small bowels and even the stomach. 

The symptoms are griping, frequent and small discharges of 
•limy matter (muc^s,) mixed with blood : the first discharges 
are usually, however, thin and watery, the bowels are tender, 
thy and hot, there is some fever, furred tongue, and sometimes 
vomiting. When these symptoms are not abated by tinaelj 



146 Incontinence of Urine. 

remedies they are apt to increase in intensity until terminated 
by death. 

Dysentery is caused by changes of weather, improper diet, 
worms, hot wet weather, impure air, want of sufficient food, 
anhealthy milk, etc. When the attack is attended by profuse 
discharge of blood the case is more favorable than if no blood 
appears. 

The diet should be restricted to animal broths, boiled rice, 
and the l'ike ; the clothes kept clean, the child put into tna 
warm bath once or twice a day, fomentations of hops and vine- 
gar, stimulating liniment applied to the bowels ; the drinks 
should be barley water, gum arabic water and flax- seed or 
slippery elm tea: injections of tea of oak bark, or starch and 
laudanum, four to ten drops, according to the age, and repeat- 
ed three times a day if needed, are also of much value. The 
allspice tea, etc., recommended under the head of Summer 
Complaint, will be found advisable also in this disease. Also 
the flannel next the skin, bathing with vinegar, etc. 

INCONTINENCE OF UMINE. 

This is a common disease among young children — and is 
often the result of a careless and filthy habit of neglecting 
the calls of nature, and not endeavoring to restrain their de- 
sires. It usually occurs at night, the child allowing the 
urine to pass even while awake, rather than to rise and 
evacuate the bladder. It is also caused by palsy of the 
bladder or some of its appendages, or by an irritable state of 
that organ. The discharge of urine is most apt to take place 
when the child is lying on his back : the urine sometimes scalds 
and irritates the legs and produces sores. Incontinence of 
urine is caused by the improper use of irritating medicines, 
certain articles of food, and by diseases of other parts of the 
body. The habit of incontinence, although an unpleasant one, 
demands indulgence and pity, rather than blame and punish- 
ment in most cases. Children thus afllicted should not be 
allowed much drink or fluid food ; they should be made to 
urinate immediately before retiring, and also to rise at stated 
hours of the night for the same purpose 

The best position in bed, in order to prevent involuntary 
discharge, is on the side. The diet should be digestible ana 
nutricious, and the bowels regular — the cold hip bath at night 
will be of service. A tea made of uva ursi, or buchu leaves, 
a table spoonful of which may be given three times a day 
often cuies the irritability of the bladder, on which the habit 
depends, or alters the quality of the urine, which causes its ia 
voluntary flow. 



Rickets — Foreign Bodies in the Nom. 147 

RICKETS. 

Rtckeis depend upon disordered nutrition, and some alter 
fttion of the blood from its healthy standard. It has usually, 
however, been supposed to depend upon a deficiency of phos- 
phate and carbonate of lime in the food, to furnish the necessary 
earthy matter to the bones — and therefore has been considered 
peculiarly a disease of the bones. But recent investigations show 
that it does sometimes occur when there is no deficiency of 
lime — and that the whole system, particularly the muscles, 
brain and nerves, are equally implicated with the bones. It 
is an affection peculiar to childhood, and supposed to depend 
upon the action of the causes which favor the development of 
scrofula. The signs of rickets are, a softened gristly state of 
the bones, large joints, large head, prominent forehead, 
straightness of the ribs and flatness of the sides of the chest, 
prominent breast bone, looseness of texture in the bones, crook- 
ed legs and distorted spine : many other symptoms of scrofula 
are sometimes also present. This, like scrofula, disposes the 
system to other diseases : the treatment of rickets is nearly the 
same as that of scrofula, (which you will find in its proper 
place in another part of this work,) — rickets, however, is a 
inore curable disease, and less apt to continue after adult age. 

FOREIGN BODIES IN THE NOSE. 

The nose, like the ear, is very liable to be made by children 
the receptacle for any thing that will pass into it; beans, but- 
tons, stoTies, &c. Sometimes they have been in the nose, 
imnoticed, for days or weeks, and are not discovered until in- 
flammation of, and perhaps discharge of matter from, the 
I ning membrane attracts attention ; a reason, when such symp- 
I oms occur in a child, for always examining the nose for the 
i resence of foreign bodies. The extraction of a foreign body 
from the nostril is always best done by a surgeon, if, how- 
ever, circumstances render it desirable to attempt the extrac- 
tion without waiting, it must be done by means of the flat end 
3f a probe, or of a bodkin, bent about the eighth of an inch, 
•early at right angles with the rest of the instrument, which 
bent end being carefully passed beyond the body, must be 
ased as a scoop to take it out. The flat end of a pair of 
iweezejjs also answers for this purpose, or use them as a pair 
nf forceps, if the foreign substance can be got hold of. Some- 
times, when the foreign body is not very far in the one nostril, 
if that on the opposite side be closed, and the child can be 
made to blow forcibly through the other, the obstruction will 
be shot out. 



148 Weak Ankles— Bronchitis. 

The lining membrane of the ncse is liable to become inflam 
ed and ulcerated. In a mild case, washing with warm wata 
—if necessary, by means of a syringe — containing a little car 
bonate of soda in solution, will be of service : soap and watei 
is also gjod. It is a common popular error to suppose that the 
nose communicates with the brain : it is sufficient to remark 
that it does not. 

WEAK ANKLES. 

If children are put on their feet when too young, before hav 
ing requisite strength, or who are allowed or taught to turn 
their toes outward too much, or those who are of a weak and 
relaxed muscular system, are apt to have weak and crooked 
ankles, or bowed legs. The soles of the feet are flat, the an- 
kles turn inward so that the child walks almost on the ankle 
joint, and with lameness and difficulty. The general health 
should be improved by a good diet, cold bathing, and exercise 
in the open air : the child should also wear high boots madt 
of leather sufficiently stiff to support the ankles in the proper 
form and position. Also use friction with the hand or rough 
towel to the legs and feet every day # 

BRONCHITIS. 

This is an inflammation of the bronchial, or air tubes of the 
lungs, and is common to childhood. It commences with chills, 
flashes of heat, slight cough, oppression and tightness in the 
chest, breathing difficult, wheezing and rattling, and hoarse- 
ness of the voice. Breathing is more distressing when the 
patient is lying down — the cough is at first dry, but a copious 
discharge of stringy phlegm, resembling white of eggs, soon 
appears, with some relief to the cough : the skin is dry, and 
the tongue is covered with a white mucus. In more severe 
cases, these symptoms may all be augmented and attended 
with much danger. The disease is caused by cold, wet, sud- 
den changes of weather, insufficient clothing, loud speaking, 
crying, dust, and noxious vapors. When a physician can be 
procured, in cases of this kind, as well as in inflammation of 
the lungs, by all means do so ; but as delays are always dan- 
gerous, while you may be endeavoring to procure a physician, 
or if ycu can not obtain one, the following course of treatment 
is advisable :— In the first place, give the child a purge oi 
say, one or two tea spoonsful of Rochelle sai'ts in a wine glass 
(or half gill) of cold water ; or castor oil will answer as well, 
made more palatable by a little essence of lemon, peppermint, 
or cinnamon. Also, of the following mixture, let the child 
lake one tea spoonM every four hours, unless vomiting is pro- 



Inflammation of the Lungs — Stammering, 149 

dnced ; if so, reduce the dose : — Take one table spoonful of 
syrup of ipecac, (or five grains of the powder,) half a gill of cold 
«rater, one table spoonful of spirits of nitre, 20 grains of 
chlorate of potash, and a few drops of essence of lemon or cin- 
namon, mix thoroughly together and keep in a cold place, to 
be used while the active symptoms continue. Also, wrap the 
chest and neck in a flannel cloth, saturated (soaked) with thii 
mixture : — Sweet oil, spirits of turpentine, spirits camphor, of 
each one ounce, to which add a table spoonful of laudanum, 
and shake well before using. Renew this twice a day. 

The child should be allowed to drink freely of cold water, 
in which put plenty of gum arabic, or slippery elm. The bow- 
els should be moved every second day, to remove the phlegm 
which is usually swallowed by the child. In robust children, 
if there is much fever and oppressed breathing, a few leeches 
applied to the chest will be advisable ; or the application of 
cupping may be tried once a day for two or three days. When 
the inflammation is somewhat reduced, applying a more stimu- 
lating liniment all over the chest will expedite the cure. A 
table spoonful of tincture of cayenne pepper added to the lin- 
iment of turpentine, &c, will be about as good as any — appli- 
ed twice or thrice a day. 

INFLAMMATION OF THE LUNGS. 

Among children, as well as adults, this is a frequent and 
dangerous disease. It begins with symptoms similar to those 
of bronchitis, and is produced by nearly the same causes.— 
The treatment is the same as in Bronchitis. 

STAMMERING. 

Stammering in the speech cannot be said to be a disease, 
being rather a functional disorder. This is evident from the 
fact, that, under certain circumstances, an habitual stammerer 
does not stammer, and that cases have occurred in which most 
inveterate stammering has been completely cured by the exer- 
tion of the will. Moreover, stammering is often caused either 
by imitation in children or by nervousness in both children 
and adults. This nervousness is often the result of debility, 
and of weak constitution — a fact which should not be lost sight 
of, for, if such be the case, every means of strengthening 
should be used. At the same time, while the general health 
is sustained, much may be done by checking children, and 
making them speak at all times slowly. Much pains with 
children, and much perseverance and self-command in adults, 
is required in the efforts to overcome this defect. Tbe ont 



150 Scarlet Fever. 

great matter of importance m curing children or others of 
stammering is, as soon as the least hesitancy in speech, ol 
stammering, is observed, make the patient stop at once, then 
draw in afuU breath, filling the lungs thoroughly, when they 
can begin again. Let this rule be observed only a short time 
and you will be surprised at the rapid improvement. The 
difficulty, in almost every case I have observed, has been that 
the person attempts to talk when he has already exhausted th$ 
air from the lungs. Overcome this, and the case is cured. 

SC AHJLET FEVER. 

In this disease, usually, the first symptom complained 
of, in the incipient stage is sore throat, either accompa- 
nied or quickly succeeded by the usual symptoms of a 
feverish attack, shivering, headache, loss of appetite, perhapa 
vomiting, followed by heat of skin, quick pulse, and thirst. 
The eruption appears early, on the second day after the first 
symptoms of indisposition. It first shows itself in the form 
of minute red points on the chest and arms, especially about 
the elbows, the points becoming more numerous, till they form 
one diffused surface of a tolerably bright scarlet eruption : 
which extends to the neck, face, and abdomen, and body gen 
erally. On the second day, when the eruption is appearing, 
the symptoms of general fever, and especially the heat of shin, 
continue unabated, the throat is more inflamed, and tha 
tongue assumes the appearance characteristic of this disease. 
It is probably covered with a white, creamy-looking fur, 
through which, on its forepart, about the tip especially, pro- 
ject red points. This appearance may continue, but i^i many 
cases the fur comes off, as it were, in patches at a tl*ne, and 
ultimately leaves the tongue preternaturally clean and red. 
The eruption in scarlet fever generally looks more patchy upon 
the extremities than it does upon the body. In a moderately 
favorable case of scarlet fever, the eruption begins to fade be- 
tween the third and fourth day from its appearance, and with 
it the feverish symptoms, and other general symptoms of the 
disease, such as sore throat, &c. The chief care is required 
until the peeling off of the skin is completed. During thu 
period also the power of communicating die disease by coita* 
gion appears to be retained. 

Favorable cases of scarlet fever pass through the course 
nearly as described above, but there are much severer fcrmi 
of the disease. The feverish symptoms from the first maj 
nave a high inflammatory form ; or the reverse may give evi 
dence of an extreme condition of bodily weakness, with a ton 



Scarlet Fever. 151 

dcncy to malignant cr severe disease. In such cases the 
eruption is slow, and, when it does appear, patchy, and dusky 
in color, the swelling of the throat is great, and, if they can 
be seen, the tonsils are evidently ulcerated, the breath offen- 
sive, the tongue swollen, and swallowing difficult, if not im- 
possible. Offensive discharges take place from the nose, and 
at the same time there is extreme weakness, with delirium. 

Scarlet fever requires confinement to bed, in a well venti- 
lated room ; the diet should be kept low, and consist of milk, 
corn-starch, farina, &c, and the patient may be freely indulged 
with drinks, such as flax-seed tea, with a slice of lemon in it, 
&c. The patient must not be so warmly covered with bed- 
clothes as to keep up feverish heat. The first thing to be 
done, in all cases of scarlet fever, is, in the very outset, to give 
a good vomit, of ipecac, so as to clear the stomach. In a great 
majority of cases this will render the disease less dangeious 
and more easily managed, and very often will almost cut 
short, as it were, or break up the disease. If the -heat of skin 
is great, sponging the surface of the body with tepid water, 
with or without the addition of a little vinegar, is at once 
most beneficial and grateful to the patient. A gentle purge 
should be repeated once or twice in the course of the disease, 
a tablespoontul of castor-oil, a dose of magnesia and rhubarb, 
or from half to a whole seidlitz powder, may be required. 

From five to ten grains (according to age) of chlorate of 
potash, given every six or eight hours, dissolved in a little 
sugar and water, is one of the most appropriate cooling medi- 
cines in this disease. 

If the feverish symptoms run high, of course the lowering 
and cooling remedies must be more actively enforced. In 
most cases much relief is afforded to the throat by the frequent 
use of warm gargles, made either with simple gruel, or with 
gruel with one or two tablespoonfuls of vinegar to each half- 
pint. Externally, hot bran or bread poultices, frequently re- 
newed, are also of much service to the throat. Great enlarge- 
ment of the glands around the jaw and in the neck must 
always be regarded seriously. When a case of scarlet fever 
presents symptoms of great severity, every method of sup 
porting the strength by wine, broths, &c, must be used, and 
the preparations of chlorate of potash employed both inter 
nally and as washes and gaigles to the nose, mouth, tonsils, 
&c. The chlorate of potash, in from five to ten grain doses, 
must be given every three or four hours ; or muriatic acid, ill 
five drop doses, in sweetened water. Two teaspoonsful of the 
solution of table salt, in the half-pint of water, will make a 



152 Scarlet Jfever. 

convenient wash, to be used with a syringe, if the child 01 
person is unable to gargle. 

After the eruption has faded, the person may sit up, and 
gradually return to fuller diet, such as pudding, broth, fish, 
&c, the bowels being kept free, but not purged. At this 
stage, too, much comfort and bensiit will accrue from the use 
of two or three warm baths. These relieve greatly the dis- 
comfort arising from the barsh and dry state of the peeling 
skin, and, what is more important, encourage and keep active 
the perspiration, which is apt to be impaired or impeded, 
and thus to give rise to one of the most serious incidents con- 
nected with the disease in question, that is, to a dropsical con- 
dition connected with a disordered state of the kidneys. Th6 
occurrence of dropsy after scarlet fever is always a serioud 
matter. It is observed that the attacks of dropsy after scarlet 
fever are by no means in accordance with the severity of tha 
attack itself, and this is supposed to be because those wb o 
have had only a mild attack are more careless as to after ex- 
posure than those who have suffered a severe one. However 
this may be, it is certain that many, who have passed safely 
through the disease itself, fall victims to the subsequent dropsy, 
purely as the result of carelessness on their own part, or on 
that of others. The attacks of dropsy are most likely to occur 
from the end of the first fortnight to the end of the fourth 
week after the decline of the eruption. Its symptoms are 
generally those of languor and oppression, with headache, and 
it may be vomiting, the swelling coming on simultaneously. 
Usually, the face (especially the eyelids) is first affected, and 
the dropsical swelling may go no further, but generally the 
feet and legs, the hands, arms, chest, &c, become filled ; the 
urine is scanty, high-colored, or " smoky" in tinge. 

Should dropsy occur^ warm baths ought to be used to re- 
store, if possible, the functions of the skin, hot bran poultices 
applied to the body, and if there is pain about the kidneys, 
blood taken by leeches or cupping. The bowels should be well 
purged. At the same time a draught, consisting of ipecac, 
spirits nitre, &c, the same as ordered in measles, maybe give* 
every four or five hours. Besides dropsy, scarlet fever is liab?t 
to be followed by other affections, particularly in those of weak 
or scrofulous constitution. If the affection of the throat has 
extended to the ears by the Eustachian tubes, which lead 
from the throat to the ear, the structure of the organs of hear 
ing may be materially damaged, and deafness, total or partial, 
be the result. Frequently, running from the ears, from the 
nose, or eyes, continue long after the subsidence of scarlet 



Prickly Heat, 153 

fever; and if the attack has been a severe one, a permanent 
state of impaired health may be the consequence. Of course, 
if a patient, after an attack of scarlet fever, remains weak 
tonic medicines (one grain of quinine three times a day, or a 
wine glass full of tea, made of Peruvian bark, cold, before 
each meal,) and good nourishment will be required — also warm 
clothing. 

Few diseases are more contagious than this, and few retain 
the power of propagation longer ; indeed, it is difficult to say 
when this totally ceases, at least for some weeks. Probably, 
when the peeling stage is complete, the risk of contagion is 
gone, or nearly so. The contagion from scarlet fever is very 
persistent, and unless the rooms which have been occupied by 
patients, and indeed everything which has been about them, 
'are very freely cleansed, aired, or fumigated, there is alwaya 
some risk for a considerable time. The power of belladonna, 
in protecting individuals against the contagion of scarlet fever, 
has been much discussed. It has been used extensively, and 
with apparent success ; at all events, the evidence is sufficient 
to make it worth a trial during the prevalence of a very severe 
or malignant form of scarlet fever. Eight grains of the ex- 
tract are to be rubbed up with a fluid ounce of water, and of 
this, from live to twenty drops, according to age, given twicp 
a day. It would be right to try the remedy during the pre 
valence of this disease, as well as measels, hooping cough, &c. 
Scarlet fever is generally a disease of childhood, and is usuallv 
passed through once in a lifetime ; but adults who have es- 
caped it early in life, are liable to be affected. Second attacks 
are rare. Although those around persons suffering from scar- 
let fever may not have the disease, they are very liable to suf- 
fer from sore-throat, often in a severe form. It is a serious 
thing for women to be exposed to the contagion of scarlet fe- 
ver soon after child-birth, and it should be avoided if possible. 
Where there are several children in a family, let those that are 
well be kept in different rooms from those that are sick with 
this disease, and the belladonna be used as directed, and let 
them be kept out in the open air, if the weather will permit. 

PRICKLY SEAT. 

The sensations arising from prickly heat are perfectly ind© 
ieiibable, being compounded of prickling, itching, tingling, and 
many other feelings for which there is no appropriate name. 
It is usually, but not invariably, accompanied by an eruption 
of vivid red pimples, not larger in general than a pin's head 
which spread over the breast, arms, thighs, neck, and occa 



154 Ming Worm. 

sionaily along the forehead. This eruption often disappear In 
great measure when the patient is sitting quiet, and the skin 
is cool ; but any exercise that brings out a pcrspiracion, or any 
warm or stimuluting fluid, such as tea, soup, or wine, bringa 
out the pimples, so as to be distinctly seen, and but too dis- 
tinctly felt. 

In reference to the imagined dangers of repelling this erop- 
ion, Dr. Johnson says — " I never saw it even repelled by the 
cold bath, and in my own case, as well as in many others, it 
seemed rather to aggravate the eruption and disagreeable sen- 
sation, especially during the glow which succeeded immersion. 
It certainly disappears suddenly, sometimes on the accession 
of other diseases, but I never had reason to suppose that its 
disappearance occasioned them." 

An application every half hour, by means of soft linen, of a 
mixture of vinegar and cold water, in equal parts, to which 
add a few drops of laudanum to each cup full of the mixture, 
and afterwards applying finely powdered starch or common 
wheat flour, is about as good as any. Strong hop tea may be 
tried. Always give a brisk purge of Rochelle salts, (one tea 
spoonful in a gill of water,) or Epsom salts will do. Low diet 
and quietude are very necessary. 

RING WOMM. 

This unsightly and unpleasant disease is too often treated 
prematurely by stimulating applications : its symptoms are 
generally well marked. It consists of minute water blisters, 
arranged somewhat in rings : it begins with slight redness — 
small blisters form and are filled with a colorless fluid — these 
break in four or five days, and are covered by a thin brownish 
scab, which falls off about the eighth or ninth day, leaving a 
red surface which gradually disappears. The eruption seldom 
lasts more than ten days, but it sometimes appears a second 
time, and continues for several weeks : it is always attended 
with itching, smarting, and burning. It often appears on the 
face, neck and arms of children — and may be communicated 
by contact. A wash of white or blue vitriol (one teaspoonful 
to half pint of water,) or nitrate of silver, (lunar caustic) a stick 
half an inch long dissolved in a gill of water, and applied once 
a day, or an ointment made of yellow dock root, boiling two 
or three of the roots in half pound of lard, for one hour, wil 
usually effect a cure. After the first and most inflammatory 
gtage is passed, the application once in forty-eight hours, o* 
tincture of iodine, or iodine ointment, applied two or three 
times, will thoroughly cure ring worm. 



Itch— OhicTcenpom. 155 

ITCH. 

This is a very unpleasant affection. It usually comes first 
between the fingers and on the wrists, in small pimples filled 
with colorless fluid, attended by intense itching, which is al- 
ways increased by heat. The friction and scratching, used to 
allay the itching, ruptures the pimples, and they are by this 
means extended to the surrounding skin. In cases of long 
continuance, some of the vesicles (or sacks) become filled with 
matter and covered with brown scabs, which extend over s 
jpeat part of the body. This disease is contagious and is com- 
municated by contact — and probably sometimes produced by 
want of cleanliness, and other causes. It seldom gets well 
without treatment: it is not dangerous, but may continue 
during the life-time of the patient, with varying degrees of 
tormenting nights and uneasy days. In neglected cases, an 
insect is to be seen m or near the vesicles. It may be seen 
burrowing under the skin, and when removed by the point of 
a needle, resembles the " cheese skipper." Whether the dis- 
ease is produced by this insect is not yet determined. Itch 
usually occurs in four or Q.ve days after exposure to its con- 
tagious matter. The best remedy in most cases, is sulphur, 
mixed with lard, (equal proportions, to which add a few drops 
of oil of lemon,) and applied night and morning to the parts 
affected: sulphur and cream tartar, mixed with molasses, 
may also be given in teaspoonful doses every night. 

The diet should be simple and digestible, the bed and cloth- 
ing of the patient kept perfectly clean and well ventilated. 
Two or three times a week, the entire surface of the body and 
limbs should be washed with lukewarm water and soap, and 
afterwards rub well with a towel, just before going to bed. 
Sponging the skin all over once a week, (after bathing, as be- 
fore recommended,) with a mixture of water and cologne 
water, or bay rum and water (equal parts,) is of service in such 
cases. 

CH ICKENPOX. 

A disease which is preceded by feverish symptoms, such at 
chilliness, quid pulse, hot skin, restlessness, diminished appe- 
tite, thirst and headache. In some cases the fever is severe, 
and attended with distressing retching, great agitation during 
sleep, and even delirium. In others it is scarcely perceptible. 
On the third day, the eruption appears, first on the body, and 
then on the face, and lastly on the extremities; when the 
eruption appears the fever declines. The pustules, which are 
ery itchy, contain a yellow matter, and by the fifth day are 

vered with scabs, which leave no pits. There are diffe* 



156 Vaccination. 

rent varieties of this disease, for in some the pustules are large! 
than in others, or go off sooner. This is scarcely ever danger- 
ous, and is seldom even troublesome ; nor is it generally ne- 
cessary to confine the patient, or do more than give one or two 
doses of some gentle purgative, such as previously recommend- 
ed in treating diseases of children. The fever and uneasy feelinga 
may be greatly mitigated, and the eruption rendered lighter 
by washing the surface with cold water in the commencement 
of the disease. The itching may be abated afterwards, by 
sponging the skin occasionally with cold vinegar and water. 
In some cases, especially if the bowels be neglected, and the 
child be allowed to eat freely, the fever will be greater and the 
pustules become much inflamed. Some of them may even 
end in sloughs, which leave deep marks, worse than those of 
the small-pox, and as in that disease, so also in this, very 
troublesome boils may harass the patient for a long time. 

VACCINATION. 

To Dr. Jenner, of England, belongs the credit of this great 
discovery, which, in the order of the providence of a merciful 
God, has been such a blessing to mankind. It is a well-known 
fact that vaccination or " cow-pox," is almost a certain pre- 
ventive of the contagious effects of small-pox. It is true, how- 
ever, that in some few cases it fails, but this should by no 
means prevent the vaccination of every child : it is thought by 
some authors, to lose its efficacy in a few years, so that a 
second or third vaccination may be necessary : this is, how- 
ever, doubtful. Children may be vaccinated at any age from 
three months upwards ; but there is some difficulty in securing 
a thorough operation of the virus in very young children, or 
in those affected with any disease of the skin. However, it 
may be performed at any time should circumstances call for 
k, owing to exposure to the contagion of small-pox. The vac- 
cine matter may be taken in the fluid state from the arm 
of another person, or a bit of the scab which has been pre- 
served, may be used. Almost any mode of vaccination, which 
will secure the formation of a pustule (pock), will answer. The 
usual mode is to raise a small piece of the skin on the arm, 
with the point of a lancet, and insert a little of the fluid or 
gcab, and cover it with a piece of'" court plaster : " or simply 
taking a blunt-pointed needle and gradually scratching th« 
arm till it begins to show signs of bleeding : then dipping tha 
point of the needle into the vaccine matter a few times, and 
working it into the skin, will answer. If a scab is used, it 



Nettle-rash. 157 

Artist be softened by a d'op of water a few minute*, till it geti 
the consistency of paste. 

Should the vaccination not take effect in four or five days, 
H should be repeated until it does, as there is no safety with- 
out it. It is always best to make one or two pocks on each 
arm. About the third day after the vaccination, there is a 
red, elevated pimple, which, on the fourth, is surrounded by a 
faint red circle ; on the fifth day there is a pearl-colored pim- 
ple filled with transparent fluid, on the eighth day the pock is 
at its height of development, at which time there is usually 
some fever, chills, lassitude, and more or less pain and swelling 
of the arm and glands of the arm-pit : by the tenth day the 
pock is led and painful, on the eleventh it begins to shrink 
and assumes a darker color, so that by the fourteenth day it is 
covered by a thick, brown scab, which falls off* about the 
eighteenth day, leaving a white scar. All the care necessary 
is to see that the vaccination passes through its course without 
getting the part injured; and should there be much fever 
give a gentle purgative. 

To preserve a " scab," keep it in a dry bottle or vial, 
wrapped in paper, and the mouth well corked, with some 
beeswax over it. 

NETTLE-BASH. 

It cannot be better described than as an eruption which 
closely resembles nettle-stings, both in appearance and in the 
§ensations it gives rise to. When acute, it is generally accom- 
panied with more or less fever. The nettle-rash, in almost all 
cases, arises from disorder of the digestive organs, caused 
either by indigestible food, or, in some persons, by particular 
kinds of food. Kernels or seeds, such as almond, peach, &c, 
which contain prussic acid, seem especially apt to cause nettle- 
rash, and in some individuals even the pips of an apple have 
been known to produce the disorder. Fish, particularly shell- 
fish, or mushrooms, also bring it on ; also certain medicines, 
§uch as turpentine ; teething in children, hurry and agitation 
t>f mind in adults, and other irritations, also give rise to 
nettle-rash. The generally known causes of this affection in- 
dicate the remedy — the removal from the stomach and bowels 
01 offending matters., If there is a tendency to sickness, and 
if the eruption appears soon after a meal, an emetic is the 
appropriate remedy ; but, whether this is administered or not 
a purgative should be given. As acid in the bowels often ac 
companies the disease, a dose of magnesia with rhubarb if 
very suitable, and, afterward, a dose of castor oil. External 



158 Indigestion — Water on ifa Jirortr* 

remedies are comparatively of little service in tftc h xtif, for^tf 
of nettle-rash. A lotion of sugar of lead, one drachm, in nail 
a pint of water, will give relief, or you may try the effect ot 
flour dusted over the surface. 

Rose-Rasb. — Occurs both in children and adults, in the 
form of rose-red patches of various sizes, somewhat resembling 
measles in many cases, but of a redder hue. The disease ii 
generally accompanied with slight fever, but the symptom* 
differ from those which accompany measles. It is devoid of 
danger, and generally subsides after the administration of a 
simple purgative. If either rose-rash or nettle-rash are 
thought to be connected with teething, the gums should be 
scarified. Wheat flour, applied to the affected parts, or pow 
dered starch, is beneficial. 

INDIGESTION. 

This is manifested by the food being imperfectly, or not at 
all, digested, but is discharged by vomiting or stool without 
being changed ; there are often no symptoms of inflammation. 
Indigestion in infants is almost invariably caused by too much 
or improper food. 

The most common symptoms of indigestion are, nausea, 
vomiting, sour odor of the breath, the milk discharged is 
sometimes curdled, and at others unaltered, and there are 
more or less griping colic pains. Children who are weaned 
early, or reared without the breast, are liable to attacks of in> 
digestion, and often become pale, weak, emaciated, the tongue 
furred, bowels bloated and tender, mouth sore, thirst, fretf ill- 
ness, moaning, eyes glassy, and finally, in some cases, death 
ends the suffering. In older children, indigestion is caused 
by unripe fruits, too much food, confectionery, pastry, impro- 
perly cooked or hard food, eating too often and at irregular 
and unsuitable hours. Affections of the brain, convulsions, 
spasm of the windpipe and inflammation, sometimes result 
from this disease. 

The child should be carried or permitted to go into the open 
air; the tepid bath and flesh brush should also be used every 
morning. Also give from four to six grains of rhubarb and 
magnesia, or a teaspoonful of castor oil, once every second day, 
and let the child's diet be so regulated as to avoid those thingi 
which have caused the disease. 

WATER ON THE BRAIN. 

Children of scrofulous constitution are most liable to this 
disease, and should be closely watched, especially from th« 



Water on the Brain. 159 

second to the sixth or seventh year of life, the most genera- 
period of attack, and particularly after the child has suffered 
from any of the diseases i icidental to childhood. At first, the 
patient is languid, looks heavy, is subject to irregular heat? 
and chills ; the appetite is variable, the bowels irregular, and 
the discharges from them unnatural in color. The sleep ia 
disturbed ; there is frequent starting, moaning, perhaps sci earn- 
ing; the teeth are grated, and the thumbs folded across the 
palm of the hand, when awake the brow is contracted ; the 
nose is continually picked, and the child, if able to speak, com- 
plains of the head, which is hot. As the disease advances be- 
yond the first stage, all these symptoms become more marked, 
and probably obstinate vomiting, and when the stomach ia 
empty, retching occurs. Toward the termination of the dis« 
ease, insensibility, dilated pupils, convulsions, etc., come on; 
but long before the latter stages, the case should be under 
proper medical treatment. The object here is to put parents 
on their guard as to the advances of an insidious and very fatal 
malady — not to induce them to incur the responsibility of its 
treatment. Many of the symptoms above detailed undoubt- 
edly occur, in less alarming combination, in many of the dis- 
eases of children ; but come as they may, and when they may, 
they should not be neglected. Some amount of treatment 
ought however to be employed to save time, and the most im- 
portant and safest indication is to give a brisk purgative, say 
one teaspoonful or two of Koch ell e salts in a teacupful of wa- 
ter. The head is to be kept cold, and quiet strictly to be ob- 
Berved. One or two leeches may be applied to the temples, 
and then obtain proper medical advice soon as possible. Its 
causes are numerous, but sometimes the disease arises without 
any being distinctly traceable ; the irritation of teething, long- 
continued disorder of the digestive organs, falls or blows on 
the head, exposure of the child's head to the heat of the sun, 
and fevers, may any of them give the first impetus to the dis- 
eased tendencies. Those children who are most liable to its at- 
tack are often the most endowed intellectually ; and there is a 
morbid tendency to excitement in the brain, which gives it 
power beyond what is natural to its age. If permitted or en- 
couraged, the child will give up the sports and exercises o f its 
Ume of life, for the sake of mental employment, and sometimes 
a parent's pride permits the erroneous system, which, in all 
probability leads either to early death from active disease of 
the brain, or to the possession in after life of a sickly bodv and 
morbid mind. In no children is it so necessary to insist up^o 
strict observance of ail the laws of physical health, previou? / 



160 Diet far Sick Children. 

treated of in this work, as in those who exhibit precocious de 
▼elopment of mind. 

DIET FOR SICK CHILDREN. 

Under this head will be found many valuable recipes for 
preparing suitable diet for the sick room. They can be relied 
on, as they have been prepared with a view to their adapta- 
tion to the delicate stomachs of children during sickness, be 
sides being " not bad to take," many of them, by well children 
or grown people. 

Panada. — tour boiling water on toasted bread, and season 
with butter, white sugar, lemon and nutmeg. 

Boiled Custard. — Beat one egg in one pint of milk, add 
salt and sugar to the taste, and boil two minutes. 

Starch Pudding. — To one pint of boiling milk, add two 
tablespoonfuls of starch, and one egg, beaten together ; season 
with sugar, salt, wine and nutmeg, and boil one minute. 

Bice Caudle. — Make a paste of two tablespoonfuls of rice 
flour in a little cold water, boil in one pint of water, and 
season with salt and nutmeg. 

Dyspepsia Bread. — Mix together three quarts of unbolted 
wheat flour, one quart of warm water, one gill of fresh yeast, 
one gill of molasses, and two teaspoonfuls of salt ; let it rise, 
and bake. 

Lemonade. — To one pint of water add the juice of one 
lemon, and the beaten whites of two eggs ; sweeten with white 
sugar. 

Orange Jelly. — Squeeze the juice from six oranges and half 
a lemon, add half a pound of white sugar, half a pint of 
water, boil, and strain through flannel ; then add one ounca 
of isinglass, and, when this is well dissolved, put it into a 
mould or dish to cool. 

Biscuit Jelly. — Soak one biscuit or Boston cracker in one 
pint of water, boil, and add white sugar, wine and nutmeg or 
lemon to the taste. 

Sago Jelly. — Soak two tablespoonfuls of sago in water one 
hour ; pour off the water and boil the sago in half a pint of 
water, until it is transparent ; then season with salt, leraon^ 
wine and sugar to the taste. 

Tapioca Jelly. — Soak the tapioca eight hours, and then pre 
pare like sago jelly. 

Isinglass Jelly. — Boil two ounces of isinglass in one quart 
of water down to one pint, and add one ounce of white lemoi 
otndv. 

M%ee Jelly. — Boil three tablespoonfuls of rice and three el 



Diet for Sick Children. 161 

white sugar, in just sufficient water to cover it, until it b» 
comes a jelly, and season to the taste. 

Calves* Feet Jelly. — Boil one calf's foot in two quarts of 
water till reduced to one pint, strain, and, when cold, skim 
carefully, and add one teaspoonful of salt, the whites of thret 
eggs, beaten with four ounces of white sugar, one gill of wine, 
and the juice of two lemons; boil the whole, stirring con- 
stantly, for four minutes, then strain through flannel. 

Moss Jelly. — Soak half an ounce of Irish moss a few min- 
utes in cold water, then drain it off, and boil it in one quart 
of water until it becomes a jelly ; strain, and season with cin- 
namon, wine and white sugar. 

Mice Pudding. — Boil one teacupful of soaked rice in one 
quart of milk, then add two tablespoonfuls of white sugar and 
one egg, beaten together, and one teaspoonful of salt ; bake 
one hour. 

Milk Toast. — Toast a thin slice of wheaten bread slightly 
brown, pour on to it some boiling milk, and season with nut- 
meg and salt. 

Boston Cracker Toast. — Split Boston crackers, toast them 
brown, pour on boiling water, and drain it off; then season 
with butter, sugar, lemon juice, and nutmeg or orange 
peel. 

Broiled Meat. — Broil the lean round or sirloin of beef or 
mutton, on the coals, until tender, and season with salt or 
tomato catsup. 

Boiled Eggs. — Boil eggs until the white is partly cooked, 
and the yolk slightly turned ; remove from the shell, and sea- 
son with salt. 

Boast Potatoes. — Koast pink-eyed potatoes in the fire until 
well done, remove the outside crust, mash, and season with 
aalt and cream. 

Oaten Gruel. — Boil two tablespoonfuls of sifted oat meal in 
one quart of water for ten minutes, then add a teaspoonful of 
*alt, one of wine, one of lemon juice, and a little nutmeg. 

Indian Gruel. Boil two tablespoonfuls of Indian meal in 
one quart of water for twenty minutes, add salt, sugar and 
nutmeg, or lemon to suit the taste. 

Sweet Corn Gruel. — Boil three tablespoonfuls of dried sweet 
oorn in one quart of water for half an hour, season with salt 
and strain through linen. 

Sago Milk. — Soak a teaspoonful of sago in a pint of cold 
water one hour ; pour off the water and boil the sago in a pint 
and a half of milk fifteen minutes, stirring constantly. Season 
with salt, sugar, ginger or nutmeg, and sometimes wine. 



162 Diet for Sick Children. 

Sago Mucilage. — Soak a teaspoonful of sago in a pint <A 
warm water two hours, then boil the same fifteen minutes 
stirring constantly; season with salt, lemon juice, sugar, nut 
meg and wine. Arrow root and tapioca maj be prepared is 
the same way as sago. 

Beef Tea. — Cut one pound of lean fresh beef into shreda, 
and boil in one quart of water for twenty minutes ; add one 
teaspoonful of salt and strain through linen. 

Mutton Broth. — Boil the same quantity of lean fresh mut 
ton and water as above, for one hour; add a few crusts oi 
bread — season with salt and parsley, and strain. 

Milk Porridge. — Boil one pint of water and one of milk ; 
add one tablespoonful of wheat flour made into a thin paste, 
season with salt and boil five minutes. 

Oyster Soup. — Boil four oysters in one pint of water foi five 
minutes, add one small cracker and a little salt. 

Barley Water. — Boil two ounces of pearl barley in o*\e 
quart of water down to one pint — season with salt, lemon a^d 
sugar, and strain through linen. 

Apple Tea. — Boil a middle-sized sour apple in one pint of wa- 
ter, strain and sweeten with white sugar. Peach tea may be 
made in the same way after removing the stone. 

Wine Whey. — Boil one pint of new milk, and while boiling, 
add a large wine glass full of sherry or madeira wine ; let it 
boil a few minutes, remove it from the fire, let it cool a few 
minutes, then strain from the curd and sweeten with white 
sugar. 

Tamarind Water. — Boil six tamarinds in one pint of water 
for ten minutes, and strain through linen. This is a gentle 
purgative. 

Currant Water. — Boil equal quantities of currant juice and 
water a few minutes ; strain through flannel and season with 
orange peel and loaf sugar Cherry water, may be made in 
the same way. 

Chicken Water. — Take half a chicken, remove the fat, 
break the bones, and boil in two quarts of water for half 
an hour; add two teaspoonfuls of salt, and strain throrgi 
linen 



Diseases of Females, 163 

DISIEL^SIES OF* FEMALES. 

MONTHLY TURNS, OR MENSTRUATION. 

This important function should be well understood by both 
aaalc and female, as by so doing many of the ills of life could 
be avoided, and things which otherwise would be mysterious 
are rendered intelligible. 

From the womb of every healthy woman who is not preg- 
nant, or who does not give suck, there is a discharge of a fluid 
having the appearance of blood, at certain periods, from the 
time of puberty to old age, called menstruation, or courses. 

Some few menstruate while they continue to give suck, more 
frequently after having suckled over six months. Some are 
said to menstruate during pregnancy, but which latter is very 
doubtful, for it will be borne in mind that the menstrual dis- 
charge is not Mood, but a secretion resembling blood, and that 
every such discharge from the womb is not menstrual, but 
may be blood, dependent on morbid action. Although the 
term unwell, is by common acceptance used among women, 
yet, a woman during menstruation cannot from that cause 
ftlone be said to be unwell, for that is a process of health, and 
which, when regular, requires very seldom more than to be 
let alone. 

This is a very important process to females, and ought to be 
particularly so to mothers who have daughters coming to ma- 
turity : that mother is very remiss in her duty who does not 
inform her child that menstruation is expected, and point out 
to her what it is, so that the child may not be taken by sur- 
prise, and through fear and alarm do things, which may lay 
the foundation of disease and unhappiness during life. The 
delicacy attendant on the subject too frequently prevents the 
afflicted from obtaining the necessary information, and gives 
rise to groping in the dark, and administering medicine at 
random. 

It should be borne in mind that the time of life at which 
menstruation commences, depends some upon the climate, 
much upon the constitution, and delicacy of living; in thi 
country, girls begin to menstruate from the fourteenth to \X\% 
eighteenth year of their age, but seldom later without incon 
venience ; but if they are luxuriously educated, menstruation 
usually commences at a more early period. About the time 
tliat the constitution is establishing menstruation, a variety of 
important changes show themselves: the complexion is im- 



164 Diseases of Females. 

proved; the countenance is more expressive and animated; 
the attitudes more graceful ; the tone of the voice more har- 
monious ; the whole frame expands; the breasts are enlarged; 
the nipples protrude, &c. 

Generally there are symptoms which indicate the change 
that is about to take place ; these are usually more severe at 
the first than in the succeeding periods, such as a sense of full- 
ness at the lower region of the belly ; pains in the back and 
inferior extremities; a slight head-ache, ringing in the ears; a 
sensation of choking or a lump in the throat ; palpitation of 
the heart ; easily affrighted by slight and unexpected noise ; 
irregular appetite, twitching of the limbs, sometimes convul- 
sions, all of which cease soon after the flow commences. The 
first discharge is sometimes very small and not colored ; for 
several times it is apt to be irregular, both as to the quantity 
discharged and period of its return, but after these it usually 
observes stated times, and nearly the same quantity at each 
visitation. The time occupied and quantity discharged, vary 
much in different women, from two to five days, and from one 
to five ounces may be stated as the average. 

Frequently it occurs when the time for menstruation has ar- 
rived and it does not appear, or when a girl begins to menstru 
ate in small quantities, or when it wants color, that instead ot 
being let alone, she is compelled to swallow one nauseous por 
tion after another, until that process by which nature wa* 
about gradually establishing an important and necessary 
change, is interrupted, and a train of morbid actions laid, 
which entail upon her a great amount of suffering. 

When about to commence, or having commenced, being 
small in quantity, the girl should be directed, during the time 
it is upon her to avoid the extremes of either heat or cold ; if 
cold weather, should add some clothing, keep dry and warm 
feet, abstain from laborious exercise, such as violent running, 
jumping, dancing, lifting or carrying heavy burdens, or any 
thing else by which the body may be strained, or the system 
over-heated ; avoid sudden exposures to currents of cold air 
when heated, or fatigued ; she should also be taught to have a 
command over her temper, so as to avoid violent outbreakings 
of anger, and paroxysms of excitement from terror or fright \ 
and she should wear flannel next the skin. Observing these 
directions, together with a moderate, rather low diet, avoiding 
all high seasoned victuals, hot aromatic teas, spiced stews, all 
and every intoxicating liquor, she should continue much hei 
usual indoor employments; and thus, the principle of letting 
well enough alone being observed, a few periods will generally 



Diseases of Females. 165 

establish the regularity of their return, on a healthy and per 
manent basis. In general, no medicine is required, except she 
be costive ; it should be removed by purgatives, such as small 
portions of Epsom salts, or castor oil, but the more violent and 
drastic purgatives should be strictly avoided. But when it 
occurs that the courses are either retarded in their progress, or 
do not appea.r, and symptoms of ill health be present, great 
eare and attention will be required, that proper remedies be 
administered. 

RETENTION OF THE MENSES OR COURSES. 

This is a condition in which the courses do not appear at the 
proper age, in consequence of which the health suffers. The 
general rules for the treatment of which are, that when robust, 
norid girls, about the age of fifteen or sixteen, begin to com- 
plain of flushings, headache, and general uneasiness, they 
should observe a spare diet, consisting chiefly of vegetables ; 
use moderate exercise, carefully avoid all that is violent, par- 
ticularly in crowded and heated rooms ; should carefully 
attend to the state of their bowels, and keep them freely open 
by saline purgatives ; such as cream of tartar, Epsom salts, 
Rochelle salts, one tablespoonful, of either, in a glass of water 
before breakfast, every second or third morning, or a seidlitz 
powder. If the symptoms continue or increase, and the dis- 
charge of the menses does not take place, take a tablespoonful 
of Epsom salts every two hours, beginning in the morning, until 
freely purged ; bathe the feet and legs, or rather sit awhile in 
warm water for several evenings ; after the bathing remove all 
moisture, and rub the feet and legs freely with a coarse cloth. 
In obstinate cases this proceeding will require to be repeated 
for two or three times, at the end of every four weeks. 

On the other hand, relaxed and feeble young women, with 
pale complexions, when they are subject to delay in the ap- 

Eearance of the menstrual evacuation, and are suffering in 
ealth in consequence thereof, should make use of such reme- 
dies as strengthen the system in general. One grain of 
quinine, taken night and morning, on an empty stomach, is an 
excellent tonic, or mix together the following : Gentian root, 
half an ounce ; Columbo root, half an ounce ; orange peel and 
wild cherry bark, each, half an ounce ; all to be beat ot 
ground fine, and put with half a pint of whisky and same 
quantity of water. Let stand for ten days, then strain, and 
take a tablespoonful half an hour before each meal, during the 
use of which the bowels must be kept open, and a more nutri- 
tious yet easily digested diet allowed. Take sufficient exercise 



166 Diseases of Females. 

in the open air, such as riding on horseback, jumping the A»p# 
in moderation, or walking with agreeable persons, so that 
cheerfulness is blended with exercise. For the same reason, a 
journey, a short residence at watering-places of public resort, 
independent of the quality of their springs, contribute greatly 
to t"ieir relief; and when the impregnation of such springs if 
chalybeate, (iron,) they may be drank with moderation, re» 
membering to precede their use by an active purge, by which 
eLalybeates and all tonics are rendered not only more safe, but 
injre beneficial. 

When the young girl thinks, from her feeling, that nature if 
milking an effort to bring forth the discharge, which is known 
by an increase of uneasy feeling in the back, hips, or lower part 
of the belly, she is to use the warm bath as before directed. 

Owing to previous debility, or other diseases, the courses are 
sometimes retained or obstructed, and no medicine or treat- 
ment will avail until the disease under which the person labors 
be removed. 

Retention of the menses for a length of time soon under- 
mines the general health, even in the best constitutions, and 
degenerates into what is called green sickness, a very danger- 
ous disease, and difficult to cure. Every symptom of feeble- 
ness prevails — a pale skin, and even a greenish complexion, 
succeeds to the rosy hue of health ; the lips and gums become 
almost white, the breath offensive, the skin under the eyea 
puffy, and of a leaden color, the whole body lax, swollen and 
doughy; the judgment, memory and natural cheerfulness im- 
paired ; the pulse is generally slow and feeble, but easily ex- 
cited, and it is then accompanied by shortness of breath, a 
palpitation of the heart, and an almost unconquerable disin- 
clination to motion ; the appetite is destroyed, and the stomach 
60 deranged that the food, instead of being digested, sours on 
the stomach. Hence the patient finds gratification in chalk, 
lime, pieces of old wall, and other improper substances; there 
ie also costiveness. 

The treatment should be more energetic under such circum- 
stances ; it should be commenced by removing the costivenesf 
by repeated dories of active purgatives, such as ten grains of 
jalap with four grains of aloes well mixed, and made into t 
bolus, or pills, with some syrup, and followed, in six lioun 
after, by one tablespoonful of castor oil, or a gill of senna tea, 
which should be repeated every four hours, until free evacua- 
tions take place ; to be repeated every two or three days, ac- 
cording to the effect of the preceding, until the feverish o* 
inflammatory symptoms have been removed ; after which thf 



Diseases of Females. 167 

eonic mixture may be used, as formerly prescribed. Daring 
the use of either of these, the bowels must be prevented from 
becoming costive ; but, should sourness of the stomach be 
present, which is known by a burning sensation at the stomach, 
sour belchings, sour taste in the mouth, soreness or tenderness 
of the stomach, particularly on external pressure, the follow- 
ing preparation should be used occasionally with the above : 
Loaf sugar, four teaspoonsful ; essence of cinnamon or pep- 
permint, two teaspoonsful ; powdered rhubarb, two teaspoons- 
ful ; carbonate of soda, one teaspoonful ; carbonate of mag- 
nesia, four teaspoonsful ; mix well in a bowl, adding half a 
pint of cold water. The dose is, one tablespoonful night and 
morning. Wearing flannel drawers, using moderate exercise, 
never going to the length of fatigue, and the aversion to motion 
to be overcome, by proposing such exercise as may be most 
agreeable, a nourishing diet, such as may agree best with the 
Btomach, is the proper course to pursue ; and at such times as 
the menstrual efforts are felt, to assist them by the hip bath, 
and friction of the feet and legs. 

SUPPRESSION OF THE MENSES. 

After being fully established, if the courses are arrested, or 
do not return at their usual period, when not caused by preg- 
nancy or suckling, it is called a suppression. The most fruit- 
ful sources of these derangements are exposure to cold, in some 
form or other, violent exercise, great mental agitation during 
their flow or immediately before their appearance. As 
soon as it is discovered that they are arrested, remedies should 
be immediately employed ; if their suppression be not compli- 
cated with general disease, it is not difficult to induce their re- 
turn. The feet and legs should be bathed, or the person should 
sit in warm water ; an anodyne may be given, such as a tea- 
spoonful of elixir paregoric, or anodyne cordial; promoting 
its operation by catmint, penneroyal, or spruce pine tea. 

Should these remedies fail, and there is pain in the head, 
back, and lower extremities, and the circulation excited, you 
should purge the bowels freely. After the free operation, give 
fifteen drops of antimonial wine, with live of laudanum, or ten 
of paregoric, in a spoonful of water, repeated every two hours, 
an til nausea be produced ; then reduce the dose to one-half. 
If the feverish symptoms still continue the purging must be 
repeated on the third day following, and either of the medi- 
cines again used as before directed ; during which time a very 
tow diet is necessary. This treatment must be pursued until 
«he fever shall be abated and the pain relieved. 



168 Diseases of Females. 

You must not expect the courses immediately to return, Lai 
probably they will at the next period be restored ; and in 
©rder to facilitate their re-appearance, an active purge should 
be administered about four days before they are expected, 
Also bathe in warm water, etc., as before. 

DEFICIENT AND PAINFUL MENSTRUATION. 

Few persons have an idea of the amount of suffering 
among females from this disease. It seldom attacks any untu 
they have menstruated some time with considerable regularity, 
and little or no pain ; afterwards, they begin to suffer more or 
less pain, which increases until it becomes grinding and severe 
as those in labor. 

It soon affects the general health ; the patient loses her com- 
plexion, and becomes very irritable and fretful. At the ap- 
proach of each menstrual period, the pain generally begins in 
the back, extends to the loins and hips, to which soon ensues 
an alternate and pressing down pain resembling in seyerity 
and suffering those of labor. At first a slight discharge takea 
place, but which suddenly ceases, after some time is renewed 
and becomes more plentiful, which, together with the pain, 
gradually ceases. The appearance of the discharge diffen 
from that of a healthy menstruation, being mixed with lumps, 
and clots of flaky matter, having the appearance of membrane 
or skin. The breasts sympathizing with the womb, frequently 
swell and become painful. Women are mostly barren ytIio 
have this disease in a severe form. 

Painful menstruation must be treated by having the bowel 
well opened a few days before the anticipated attack, in bein& 
confined to a very light vegetable diet, strictly avoiding the 
use of all spiritous liquors. The patient should be kept in bed, 
drink freely of tea made either of penneroyal, catmint, sage, or 
the leaves of spruce pine, until the discharge be fully estab- 
lished ; after which the pain seldom returns for that period. 
Bateman's drops, or tea made of the bark of the root of tulip 
poplar tree, lovage, tansy, hops, or black snake root, may be 
used. What I have found the best in my own practice is this : 
Get at a drug store four ounces of tincture of ergot ; com- 
mence about a day or two before the expected return of the 
monthly sickness, and take a teaspoonful every four hours, 
until the discharge is fully established. Take a purgative before 
commencing with the ergot. Do the same way for two or thiree 
periods of the courses. The directions heretofore given as re- 

Sards diet, clothing, and exercise, keeping the feet warm and 
ry, and the bowels open, together with an occasional use oi 



Diseases of Females. 169 

the warm bath should "be strictly adhered to, and persevered 
in for a considerable length of time. Sometimes one or two 
grains of powdered ipecac, or half a teaspoonful of the syrup 
taken every two hours, will bring on the flow freely, when 
other means fail. Keep warm in bed while using the ipecac. 

PROFUSE MENSTRUATION. 

There is a great difference in different women as to the 
amount of the discharge during their courses. When a 
scanty evacuation is followed by a general uneasiness, a sense 
of fullness, flushing and headache, it is to be considered a 
suppression ; and when a considerable flow is followed by lan- 
guor, paleness and general weakness, it is to be considered 
as profuse, and should be checked. 

If feverish symptoms, such as headache, oppressed breath- 
ing, increased heat, and a full, firm pulse, precede or accom- 
pany a sudden and profuse flow of menses, the evacuation fre- 
quently becomes its own cure ; and if the woman be careful to 
keep her bowels open by moderate purgatives, to observe a 
spare diet, to drink only cold water, to keep her person cool 
b\ thin clothing, sleep on a hard bed, and have free exposure 
to the open air, she may not only moderate the evacuation in 
future, but probably will derive considerable advantage from 
its present excess. But if, notwithstanding these precautions, 
the flow continue or return, still accompanied witli the above 
febrile symptoms, she must take a brisk purgative of Epsom 
salts, or senna and salts, to be repeated until full and fret 
evacuations from the bowels take place. Also if necessary, 
take one or two grains of ipecac, or a half teaspoonful of the 
syrup of ipecac every two hours until sickness at the stomach 
is produced, hut not vomiting. 

Should there be such a profuse flow as to cause great pros- 
tration, faintness, vomiting, the lips becoming pale, nails blue, 
extremities cold, with convulsive twitchings, the danger is 
great, and it is then no longer profuse menstruation, but must 
be considered a true uterine hemorrhage j she must lie down on 
a hard bed, and be kept perfectly quiet. Motion of every kind 
must be forbidden, not even permit her to turn herself; she 
must be freely supplied with fresh air, or the use of the fan 
drink cold, or even iced water ; bladders half filled with cc d 
water, or cloths wrung out of cold water, applied to the belly, 
and frequently renewed, provided there is no chill on her at 
the time. These, together with oak bark tea, or alum whey 
every hour or two, with the addition of from ten to fifteen 
drops of laudanum to each dose : all to be given cold. These 



170 Diseases of females. 

proceedings generally give relief, or at least will co itrol the die 
ease, and probably preserve life nntil medical aid can be pro- 
cured, which should always be had if possible. After the 
hemorrhage has been moderated, she must for many days 
avoid exertion, remaining in bed, be confined to a strictly 
vegetable diet, and avoid every kind of spices, and also all 
spiritous and fermented liquors. Keep her bowels open by the 
use of purgatives, such as Rochelle salts — one teaspoonful in a 
glasfi of water — castor oil or magnesia, taking three times a diy 
some light tonic bitters, such as cold watery infusion or tea 
made of wild cherry bark, thorough wort (boneset) or dog- wood 
bark, and while the body is to be kept cool, the feet are to be 
kept warm and dry ; if they are cold, they must be frequently 
rubbed with a woolen cloth or flesh-brush. 

CESSATION OF THE MENSES . 

As a general rule, a woman ceases to have the menstrua 
flow between the age of forty and fifty ; in some women gradu- 
ally, in others more suddenly. This is an important and criti- 
cal period of a woman's life, and great care is to be exercised 
that the health of the patient be not injured by improper treat- 
ment. The greater number of cases require only to be 1st 
alone ; many, particularly the weakly, will probably be bene- 
fited by the cessation, and will enjoy better health. When, 
therefore, this discharge shall decline or altogether cease, and 
not be succeeded by other disease, it will require no other at- 
tention than a strict regard to temperance, so as not to inter- 
rupt nature in effecting an important change. But in constitu- 
tions in which there is a predisposition to some disease, the 
cessation, more particularly the sudden stoppage of the courses 
will expose the woman to an attack of that disease. Therefore, 
u upon the decline of menstruation there shall occur general 
icverish uneasiness, such as flushings, restlessness, headache, 
throbbing, either in the head or under the ears, singing 01 
ringing in the ears, dizziness, daning pain through the head, 
palpitation of the heart, piles, hard or painful swelling of the 
legs, it will then be necessary in addition to strict temperance, 
both as regards body and mind, to keep the bowels freely open 
by the occasional use of salts, seidlitz powders, castor oil, senna, 
or if necessary, more active purgatives, such as cream cf tarfcax 
and jalap, etc. These remedies and precautions will have to 
be persisted in for some time, at such intervals as the urgency 
of the symptoms may require, and should be so timed as to 
anticipate the attacks, until the system becomes used to the 
change. 



Diseases of Females. 171 

At this time of life, soma women, instead of the mensea 
ceasing, become subject to repeated and excessive discharges; 
Jn such cases, before the patient becomes weakened by ex- 
haustion, and if the discharge be accompanied by fever, it will 
be necessary to use gentle laxatives and anodynes, such as a 
teaspoonful, each, of cream of tartar and sulphur in a glass of 
water before breakfast. Also put one tablespoonful of spirits 
nitre in a tumbler of cold water, and take one tablespoonfml 
every three hours. As an anodyne, take half a teaspoonful of 
paregoric in a little water at bed time. But if such discharge* 
Decome so excessive as to come under the denomination of 
uterine hemorrhage as formerly described, the case should be 
treated the same as advised in that disease. 

If it occurs that a woman, after menstruation has ceased for 
a few periods, becomes again subject to discharges either of 
blood, or matter resembling that from a boil, especially if it be 
accompanied with pain at a particular spot, darting from thence 
across the abdomen, through the hips or down the thighs, there 
is reason to apprehend cancer, or other serious ulcers in the 
womb or adjacent parts. It is advisable to have such case* 
placed under medical advice. Nothing has a greater tendency 
to retard the progress of these cases, than a strict regard to 
temperance, and nothing will more surely hasten their ad- 
vancement into incurable disease than the opposite course. 

TTTEBINE OB WOMB DISEASES. 

Fluok Albus, ok Whites. — Female weakness, (as this dis- 
ease is often called,) is among the most prevalent ailments 
among women : even young girls before marriage, are often 
troubled with it without applying for medical aid, owing to 
false notions of modesty. It is a discharge from the privates, 
not colored with blood; in general, if the disease be not the 
consequence of falling down of the womb, or other organic 
derangement of that organ, the discharge is easily arrested, 
when taken in the first stage. At first, it is in most cases 
strictly local, but if suffered to run on, its necessary conse- 
quence is to undermine the constitution, and ruin the general 
health. The discharge is at first mild and semi-transparent, 
resembling in appearauce that of the white of eggs, or thin 
starch made by boiling ; but becomes in its progress opaque 
or milky, yellow, greenish, and scalding — so much so as to ir 
ritate and inflame the parts over which it passes. In the first 
•tage it is acconipaa ied by little or no pain, but as it progress- 
es towards the second, and succeeding stages, the person suf- 
fers from loss of appetite, pain in the back and loins, wearineai 



172 Diseases of Females. 

and fever. When persons of a robust and full habit are sub 
ject to this disease, or when it occurs in more delicate con* 
stitutions, but accompanied by a feverish state of the system, 
the treatment should be commenced by a purgative of tet 
grains of rhubarb, a dose of senna, or castor oil. A cooling 
and spare diet is absolutely necessary, and cleanliness must be 
strictly enforced. In order to secure this latter requisi,e, 
(which is all important to the speedy termination of the dis 
ease,) injections of luke-warm water, or milk and water of the 
same temperature, should be thrown up the privates three or 
four times a day : this may be accomplished by the use of the 
female syringe, to be obtained at most drug-stores. When the 
feverish state of the system is thus in some degree subdued, 
gentle astringent injections will be proper ; such as weak tea 
of white oak bark, with or without a small portion of alum ; 
or 20 grains of white vitriol, 100 drops of laudanum, and half 
a pint of water, to be used three times daily. Injections of 
green or black tea, very strong, or tea made from sassafras, 
sage, or dogwood bark, (cold) thrown up the private parts three 
or four times a day ; also, at the same time, washing the outer 
parts in cold water, and always keep the bowels open, is ad- 
visable. 

When the disease has already progressed until it has passed 
the inflammatory stage, or is not originally attended by a 
feverish state of the system, but by general weakness ; an ina- 
bility or disinclination to exercise ; pain in the back and loins, 
"want of appetite, &c, — after the purging, as above directed, 
and during the use of the astringent injections, the tonic bit- 
ters previously mentioned, (of wild cherry bark, &c.) together 
with bathing the outer parts in cold water thoroughly three 
or four times a day, should be used. In those cases in 
which the discharge is offensive and of a greenish color, or re 
sembling matter discharged from a boil and streaked with 
blood, it is advisable for the purpose of cleansing out the va- 
gina, (or canal,) first, immediately preceding each astringent 
injection, to throw up a few syringes full of weak soapsuds. 
Too great attention cannot be paid to cleanliness, and indeed 
all other directions are useless if that be neglected. The outer 
parts should be well washed with soap and water two or three 
times a week. If this course of treatment does not effect ft 
cure, make no delay in seeking advice of a physician. 

FALLING OF THE WOMB. 

When a prolapsus takes place, an uneasy dragging sensation 
is felt ix the loins while standing or walking ; a mucous dia 



Diseases of Females. 173 

charge is perceived, sometimes bloody, accompanied with a 
kind 01 pressing or bearing down ; an inclination to go to 
stool, frequently a light slimy purging and a sense of numbness 
shooting down the thighs ; when first rising from a lying to a 
standing position, a sensation of falling from above into the 
passage below, which prevents the free evacuation of urine ; 
these symptoms all subside, or are much mitigated by lying 
down. Whatever weakens the parts concerned, has a tenden- 
cy to produce this disease : such as, frequent miscarriages ; 
improper treatment during labor; severe and protracted 
labor ; the use of instruments in delivery ; too early 
rising, and too violent exercise after delivery ; improper 
treatment of profuse menstruation; long continued whites; 
violent exertion during menstruation, such as jumping, 
dancing, lifting heavy weights ; blows on the abdomen, 
&c, are the most frequent causes. The means of cure, 
in those cases in which the womb will not return to its 
place on lying down, is to lower the head and shoulders, whilst 
the hips are somewhat elevated, then witli the finger oiled, 
gently press the prolapsed part into its proper situation, and 
lie down for many days, or in severe cases, weeks, and two or 
three times a day make use of astringent injections as men- 
tioned in treating whites. If the bowels are costive, some 
gentle cathartic, such as castor oil, seidlitz powders, magnesia, 
<fcc., should be administered, but all irritating purgatives, as 
well as stimulating diet aud drinks, strictly avoided. If these 
means fail, recourse must be had to the use of a pessary, which 
can be obtained at most any drug-store. The " King Pessary" 
we consider preferable. It should be taken out once or twice 
a week, and washed in soap and water; and at the same time* 
inject a pint of cold green tea up the privates. 

PBEGNANCY—Its Signs and Diseases, 

During pregnancy, the natural irritability of the womb 
being increased, manifests itself by a variety of symptoms and 
sympathies. Although such symptoms may, and frequently 
do, arise from other causes than pregnancy, still, when a 
healthy married woman finds that the menstrual discharge 
does not return at its usual period, finds her breasts enlarge, 
%nd the circle which surrounds the nipple change from a light 
pink to a dark brown color, and that siie soon after becomes 
subject to languor, nausea, and vomiting in the morning, 
faeart-burn during the day, and some degree of restlessness 
and want of sleep during the night, she may with confidence 
attribute those symptoms to pregnancy. Women who hava 



174 Diseases of Females. 

borne children will, in consequence of their peculiar feeling* 
formerly experienced, seldom be mistaken in their judgment 
whilst those who wish to hide their pregnancy, and other! 
from an overweening anxiety to have children, will be led into 
many ridiculous and frequently dangerous errors. As all, 01 
at least most, of the symptoms above mentioned may be pre- 
sent, yet no pregnancy exist, therefore, in cases of doubt, it 
would be most expedient to act as though it did, for, about the 
end of the third and beginning of the fourth month, the rising 
of the womb, and the feeling of a tumor or fullness below the 
stomach — and, between the fourth and fifth month, the motion 
of the child, termed " quickening" — will, generally, put the 
matter beyond doubt ; no risk can be encountered by thus de- 
laying any measures which might have an injurious tendency 
in case of pregnancy. 

Diseases of Pregnancy. — A common attendant on early 
pregnancy is a slight degree of feverishness, but which omlestf 
excessive or accompanied with other diseases, will seldom re- 
quire any other remedy than to open the bowels, and a low 
diet, of which fruit and vegetables should form the principal 
part ; there is generally a dislike to animal food of every kind, 
and it should be avoided as much as possible, for, if indulged 
in, it gives rise to much inconvenience. Another means of 
keeping up a healthy action, and thereby obviating the effects 
of iever, is moderate exercise in the open air. It is a mistake 
to suppose that pregnant women should be encouraged in 
living more luxuriously and indolently than what is habitual 
to them ; they should, therefore, not be confined to close or 
heated apartments, but bo allowed a full share of out-door ex- 
ercise, yet be cautioned to guard against extremes, such as 
carrying or lifting heavy burthens, running, jumping, dancing, 
&c. The irritation of the fever will cause them to be fretful, 
peevish, and desponding, which is often by others mistaken 
for ill-temper, which erroneous opinion only leads to further 
inconvenience and unhappiness. Women, whose happiness 
always is a matter of deep interest to the civilized man and 
Christian, are, during the state of pregnancy ', more than at 
any other time, entitled to the tender regard and affectionate 
consolation of their friends, particularly of those who claim 
the title of husband. The desires and dislikes of pregnant 
women should not be overlooked, and the effects of despond- 
ency prevented by kind words and by everything calculated to 
pucourage them. 

Frequently the feverish heat, full pulse, headache, uneasinesi 
end restlessness continue to increase as pregnancy advance*, 



Diseases of Females. 175 

becoming sometime* very distressing and alarming ; recourse 
should, then be had to purgatives, after which two or three 
doses of soda powders, during the day, or cooling drink of 
water, acidulated with lemon juice, vinegar, cream of tartar, 
tamarinds, cherries, plums, &c. The mild purging may be 
•epeated as occasion requires, but should not be excessive, or 
inch as produces griping. 

Morning sickness is one of the early symptoms of preg- 
nancy, which generally ceases after quickening, and returns 
towards the conclusion, sometimes at intervals during the 
whole period, which, when moderate and confined to the earl} 
part of tbe day, should be left to nature, not being of a dan- 
gerous tendency, but generally found serviceable, as a woman 
will generally find she enjoys more ease during the remaindei 
of the day after having vomited in the morning than when 
she has not. 

When sickness and vomiting prove more severe, and the 
stomach continues to reject the food taken during the day, re- 
course should be had to medicine. "When the vomiting is ac- 
companied by a costive state of the bowels, a tablespoonful of 
carbonate of magnesia should be given several times during 
the day, until they are moved, and continued once or twice a 
day for some time ; or the following : water, one gill ; loaf 
sugar, two teaspoonsful ; essence of cinnamon, one teaspoon- 
ful ; rhubarb, one teaspoonful ; calcined magnesia, one tea- 
spoonful — mix together. 

Of this mixture one tablespoonful may be given every four 
hours. A seidlitz powder taken occasionally will be found 
useful. If the vomiting be accompanied by a diarrhoea, a tea- 
spoonful of prepared chalk, diffused in cold water, three or 
four times a day, soda powders, lime water and sweet milk, or 
a piece of flannel moistened with laudanum and camphor ap- 
plied to the pit of the stomach, will all prove very service- 
able. 

Heartburn is a painful sensation of heat in the throat and 
stomach, attended with a sudden coming up of thin, sour 
froth into the mouth. There is often reason to think that it is 
occasioned by food highly seasoned, or not easily digested, and 
by fermented liquors — and sometimes by sleeping in a sitting 
\mture after a meal — but it most frequently depends upon 
some sympathy of the stomach with the womb, and although 
more disagreeable and difficult to remove than dangerous, and 
always removed by delivery, yet there are some casos which 
are extremely distiessing, and cannot be considered as entirely 
void of danger. 



176 Diseases of Females. 

Even if we cannot remove this unpleasant attendant on 
pregnancy until after delivery, it may oe much mitigated bj 

fiving, two or three times a day, a large teaspoonful of car- 
onate of magnesia, or prepared chalk, m cold water ; a table- 
spoonful of lime water, or ten grains of carbonate of soda iD 
a gill of fresh water. In obstinate cases, the following will 
be found a very beneficial piescription : "Water, half a gill \ 
essence of cinnamon, one teaspoonful ; calcined magnesia, one 
teaspoonful ; hartshorn, ten drops ; mix and put into a bottle. 
Two or three teaspoonsful may be given occasionally, particu- 
larly after meals, each dose to be taken in a large tablespoon- 
ful of water. If costiveness prevails, it should db removed by 
gentle purgatives. Magnesia is among the best in this case. 

Costiveness is one of the most prevalent, as well as the most 
obstinate, diseases of pregnancy, and is, generally, most ns- 
glected. When excessive, it gives rise to many other affec- 
tions, such as colicy pains, headache, flushing of the face, 
frequent desire to make water, unavailing straining at stool, 
piles, palpitation of the heart. Costiveness, if not the cause 
of vomiting, heartburn, and flatulence, is known much to in- 
crease them; and there is much reason to believe it is frequently 
the cause of abortion, and therefore of much importance that it 
should be removed. But, in accomplishing this, care should 
be used to select proper purgatives, strictly avoiding all such 
as are griping, as profuse purging is hurtful in pregnancy. 
Small doses of Epsom salts, seidlitz powders, manna, senna 
and manna, castor oil, rhubarb, sulphur and cream of tartar, 
are the most proper purgatives. These ought to be used in 
rather small and repeated doses than given largely. 

Much may be done to remove this unpleasant state of tho 
bowels by a suitable diet. Bread made of unbolted ground 
flour, (called sometimes " Graham flour,") and bran tea, sweet- 
ened with molasses, or manna, deservedly rank high ; also such 
other articles as are known to have a laxative effect upon the 
bowels should not be neglected. Stewed fruits at meals, or 
ripe fruit uncooked, once or twice a day, or a roasted apple at 
bed time, assist in keeping the bowels open. If the bowels 
have been in a costive state for many days, it will always be 
advisable to assist the operation of the medicines by an injec- 
tion, composed of a pint of milk and water, with the addition 
©>f a tablespoonful of melted lard, or sweet oil, which will 
facilitate the evacuation, and cause the medicines to operate 
with less pain and sickness. 

Piles. — They are a cause of much suffering to pregnant 
women, and, in consequence of the delicacy attendant, thej 



Diseases of Females. 177 

vill generally suffer a long time in silence rather than apply 
for aid. 

The treatment proper for this disease will be found undo, 
the head of Piles, in another part of this work. 

Strangury, or Pain and Difficulty in Urinating. — This 
is a frequent desire to pass the urine, and painful discharge in 
gmall quantities. It is sometimes caused by not complying 
with the calls of nature, and retaining the urine toe long, but 
most frequently arises, during the early period of pregnancy, 
from the sympathy which exists between the womb and blad- 
der ; subsequently, from the pressure of the enlarged womb, 
a retroversion or falling down of the womb, from its pressure 
against the neck of the bladder, may also give rise to it ; in 
such cases, a tumor in the passage will be evident. For the 
relief of "strangury, the bowels should be moved by laxatives, 
assisted by injections up the bowels of lukewarm water, in 
the meantime drinking frequently of tea made either of elm 
bark, marsh mallows, flax-seed, parsley root, or lovage, adding 
three or four times a day, to some of the tea, twenty drops of 
spirits of nitre, and five drops of laudanum, or, in the place 
of the laudanum, twenty of paregoric. Should the strangury 
be caused by the falling down of the womb, it must be re- 
moved by replacing it according to the directions formerly 
given, and, while so attempting to replace the womb, let her 
make effort to void urine ; and if the bladder be thus emptied 
the tumor will probably return by further gentle pressure up- 
wards, and, if so, she should keep her bed for some days. 

iTcniNG of the Outer Parts, with an irresistible desire to 
scratch, is, in some cases, a very distressing complaint, more 
so, as women will suffer intense misery in silence, and, even 
when forced to consult medical men, will not make it known, 
unless drawn from them b} r close and repeated questioning. 
Women are liable to this affection at any time of life ; it is 
frequently dependent on some disease of the bladder or womb, 
and when so no treatment will avail as a cure, unless the 
primary disease be first removed; it is also sometimes an 
original disease, and sometimes appears to be caused by the 
pregnant state, and in all cases where having previously ex- 
tftea is much increased during pregnancy. Use the following 
c.ixture : Water, half a pint ; borax, three tablespoonsful 
fcir.clure of myrrh, one tablespoonful ; laudanum, one tea- 
spoonful. To be injected into the passage, two, three, or four 
times a day, and during the intervals to keep pledgets of old 
linen, or a soft sponge, moistened with the same, in close con* 
tact with the outer parts, where there is the most itching 



178 Diseases of Females. 

Avoid scratching as much as possible. The bowels should bt 
kept well opened by proper purgatives. Wet tea leaves o? 
hops applied to the parts are often beneficial. 

Ckamps, in the legs, which are very troublesome sometimes 
may generally be relieved by some stimulating liniment o* 
mixture of vinegar and mustard rubbed on the parts. Mort 
exercise should be taken. 

ABORTION, OR MISCARRIAGE, 

Is the expulsion of the contents of the pregnan"- womb, at a 
period of pregnancy so early as to render it impossible for the 
life of the child to continue. 

Although in many cases no evident cause can be assigned 
for the production of this unpleasant occurrence, it may be 
mostly traced to some of the following : violent exercise ; 
severe fatigue ; sudden exertion ; contusions or shocks on tbe 
body ; heating and stimulating food ; indulgence in spiritoi t 
and other intoxicating liquors ; violent operations of emeth & 
and purgatives ; fear, grief^ and excessive joy ; a full gross hab ;t 
and feverish state of the system ; exciting and debilitating dis- 
eases. A delicate frame, and weakly constitution, will prj 
dispose to it, yet, there are some in whom there exists a 
predisposition to abortion, and who nevertheless appear other- 
wise healthy ; in such, the slightest causes will excite the Womb 
to cast off the contents ; and having once done so, are apt to 
miscarry again, and if the habit be once acquired, it becomes 
very difficult to remove — ruining the health of women, and 
disappointing the fondest hopes of parents. 

The first symptoms are, the absence of the usual morning 
sickness, a subsidence of the breasts, discharge of water or of 
blood from the womb, commonly known by the name of flood- 
ing ; pains in the backj loins, and lower parts of the belly 
coming on in paroxysms with intervals of ease, resembling 
those of labor. 

The hemorrhage being the surest symptom of abortion, de- 
mands our first regard, for if it continues, abortion must ensue. 
If then, this alarming symptom be present, our only hope liea 
in restraining it. Yet it must be borne in mind that frequent- 
ly the hemorrhage is the effect of the aborting process already 
going on, and therefore the discharge cannot be stopped until 
the contents of the womb have been cast off; but still we can 
generally, by correct conduct, su modsrate it that the womae 
will be sustained, and her life be preserved. 

The bowels must be attended to * if costive, to be opened 
by some gentle purgative, (Rochelle salts or castor wil,) and 



Diseases of Females, 179 

if diarrhoea be present, it must be relieved by a few drops of 
laudanum or of paregoric. She mast lie down and keep quiet y 
Dn a hard bed with light covering ; every thing that will 
heat the body and quicken the circulation must be carefully 
avoided, cold air freely admitted into the room, and she be 
kept perfectly still, every kind of exertion strictly forbidden, 
even to conversing with her friends ; the diet must consist 
wholly of vegetables, fruits, butter milk, cold water, lemon- 
ade ; all cordials, spiritous liquors, spices, and stimulating food 
amst be rejected. Cloths wrung out of cold water, or vinegar 
and water, should be applied to the back, bowels, thighs, and 
external parts ; and when the heat of the body is considerable, 
and the hemorrhage profuse, the coldness of these applicationa 
may be increased by ice or snow ; but these cold applicationa 
are limited to the stage of excitement, and to be discontinued 
dn their producing pain or a continued chill. If the fever ia 
reduced, and the system brought rather below the natural 
heat, then, if there be a continued pain, thirty or fifty drops of 
laudanum, given in a spoonful of vinegar, or one-fourth of a 
grain of opium, with half a grain of ipecac made into a bolus, 
two, three, or four times a day, will abate it. But if the paina 
be in paroxysms, with ease between them, and bearing down 
with expulsive effort, and more particularly if this kind of 
pains have preceded the flooding, then opium and laudanum 
a 'e improper, as they will prolong the suffering. Yery little 
expectation can be had of saving the child, our attention must 
then be directed chiefly to the saving of the mother ; for if the 
contents of the womb must be parted with, the sooner the 
better — which laudanum and opium retard. The aforesaid 
ti eatment to be pursued steadily from day to day, until all 
appearance of abortion shall have vanished, and then to try, 
by rising slowly and without exertion, whether she is safe in 
60 doing ; but on the least appearance of the return of flood- 
ing or pain, again resume the bed as before. During all thii 
time the bowels must be kept gently open. 

If the case be one of exhaustion, of which if the reader will 
judge by the symptoms before mentioned as indicative of that 
etate, the treatment must be varied accordingly. Before she 
has been brought into this state, she will probably have flood 
id much, and the hemorrhage will be considerably diminished 
at least foi the time. Fainting, or disposition to it, will then 
be the most prominent and alarming symptom, which is not 
only a consequence of the loss of much blood, but is the 10 
medy which nature makes use of to check the further effusion. 
This, although very alarming to those unacquainted witli its 



180 Diseases of Females. 

good effects, should not in recent flooding be interfered with; 
no efforts should be made to rouse her, or prevent a recurrence 
of fainting by administering cordials or other stimulants ; but 
she should be left in that languid state which always accompa- 
nies fainting : during which the blood moves slowly through 
the vessels, and an opportunity is afforded for the mouths of 
the bleeding vessels to contract, the blood to coagulate, and 
the bleeding to be stopped. When some time has been allow- 
ed for the contraction of the blood vessels, and coagulation of 
the blood, and the fainting should still continue to an alarm- 
ing degree, dash cold water on the face, give a tablespoonful of 
wine, or a teaspoonful of brandy, or camphorated spirits, or 
twenty drops of ether, in fresh water, which repeat every ten, 
twenty, or thirty minutes, as the recovery may be quick 01 
slow, having regard to the hemorrhage ; if it show a disposi- 
tion to return, desist from the brandy, &c, which, at all 
events, must be used no longer than absolutely necessary to 
call back the powers of life, which, when recovered, must be 
left to themselves ; keep her perfectly quiet, not permitting 
her to speak or move hand or foot. After being somewhat 
restored, having still hopes of averting the abortion, and there 
be pain, opiates may be given, as before mentioned, a soda 
gowder, in the state of effervescence, given a few times at in- 
tervals of a few hours, and if there be still a slight discharge, 
alum whey may be given. 

Occasionally cases of pregnancy occur, accompanied by a 
glow or chronic hemorrhage, continuing for many days in a 
small degree, sometimes being scarcely perceptible, at other 
times more profuse, but not sufficient to excite much alarm, 
until some new excitement or exertion, suddenly brings on for- 
midable hemorrhage, and abortion with great risk of life to 
the woman, takes place. A dull, heavy, aching pain in the 
back, at all times easily excited into a sharp, pungent pain, 
darting through the womb, in different directions, and down the 
thighs is commonly attendant. 

In such cases the most perfect quietude in bed must be ob- 
served, and the mind kept tranquil, and free from every excite- 
ment or care. Also injections of cold green tea two or three 
times a day up the privates, may be employed, and cloths 
wrung out of the same laid across the bowels, renewing the 
application frequently. 

Abortion from External Violence. — External violence is 
very frequent cause of miscarriage. A pregnant woman hav 
mg received an injury from which abortion might be appre- 
hended, should immediately be put to bed, and kept periectljf 



Diseases of Females. 181 

quiet ; if chilly, some warm u not hot tea, be given her for drink, 
and moderately warm covering, but no longer than the chill 
may continue ; as soon as that is off, or if no chill has taken 
place, then to be kept cool, admitting the fresh air freely, and 
cold water for drink, and when fever shall succeed such injury, 

five a dose of Epsom salts, or Rochelle salts. When the 
owels have been freely moved, put one teaspoonful of spirits 
fcitre, one of paregoric, and twenty drops of essence of pepper* 
went into a tumbler of cold water, and of this mixture let a 
tablespoonful be taken every hour or two. 

Of course, rest in bed must be enjoined, and perfect quiet, 
•tc, as before mentioned. Also the cold green tea to the 
Dowels. 

In all cases where there is reason to fear abortion, a state of 
absolute rest in bed is to be enforced with great perseverance, 
as the first rule of practice. By rest alone, without any other 
assistance, hemorrhages may be restrained and abortion pre- 
vented ; but without it, no woman can be safe. All other 
means will be unavailing unless assisted by rest. Even after 
the immediate alarm of the attack is over, and she be in a pros- 
perous state of recovery, she must still recollect her danger. 
She should be confined to a hard bed, for several days alter, 
and keep her room for a much longer period. 

If an abortion does take place even after all that can be done, 
the case must be treated the same as after an ordinary confine- 
ment. 

Swelling of the Lower Limbs. — This is sometimes very 
troublesome ; it can, to a certain extent, be relieved by keep- 
ing the bowels open, and giving fifteen drops of spirits of nitre 
in half a glass of cold water three times a day. 

Palpitation of the Heart — When it occurs in pregnant 
women, may be relieved by taking fifteen drops every four 
hours of a mixture composed of equal parts of tincture of vale- 
rian and spirits of lavender in a little water. Take more exer- 
cise and avoid costiveness of the bowels. 

Bandaging the Bowels , for a length of time before confine- 
ment, is of very great benefit, with delicate females, or in casei 
of unusual enlargement. 

The Nipples. — During the last months of pregnancy they 
ihould be daily bathed in a tea made of oak bark, borax, or 
alum water, or strong green or black tea (cold). This will 
harden or toughen them so that they are not near as likely to 
become sore, soon after confinement. And women who are 
iubject to having sore nipples, should draw them out with a 
breast-pump, or get a friend to do it for her once every day 



182 Midwifery. 

during the last four or fire weeks before confinement. They 
thus become hardened beforehand. 

Too much on the Feet. — It is not good for either the mother 
or her child, for her to be too -much in the erect posture, more 
especially those of a delicate constitution. Sitting down or lying 
down for a few mmntes at a time, several times during the day, 
will be of signal beneiit, as it keeps the womb from settling 
down too low. 

Cramps in the Stomach, may be relieved by drinking a few 
•poonfuls of a tea made of cloves and cinnamon, repeated as 
occasion may require. 



MIDWIFERY. 

LAB OB. 

This takes place at the completion of the term of pregnancy, 
a period of about forty weeks, or nine months. At this period, 
the child being able to live without its connection with the 
mother, the womb begins to contract itself so as to lessen its 
cavity, and tnereby expel or thrust off its contents, which 
are propelled downwards, towards the mouth of the womb, 
which opens and dilates so as to give them a ready exit, at the 
same time those parts through which they are required to pass, 
assume a disposition to dilate or open. 

Natural Labor. — All such as come on at the full period of 
nine months, in which the head of the child presents or comes 
drst, and which are completed by the unaided efforts of na- 
ture ; are so denominated from the frequency of their occur- 
rence, and the regularity with which they proceed. 

The first stage of labor commences with the true labor pains, 
&nd ends when the mouth of the womb is completely opened, 
tebout the time the membranes usually burst and the waters 
•re discharged. The second stage is occupied in the passage 
of the child's head so low as to begin to press lpon, and to 
dilate the external parts. These two stages frequently go on 
together, although the mouth of the womb is usually dilated 
before the head has descended low down ; yet it semetimef 
happens that, it is unyielding and not disposed to dilate, aa4 
therefore descends before the head, which is thus covered by the 
neok of the womb, presents at the external opening The 
third stage of labor commences with the distention of the ex- 
ternal parts into the form of a large protuberant tumor, and 
contiuues until the external orifice shall be so far dilated as tc 



Midwifery. 183 

suffer the child to pass through it. The last stage is taken up 
in the care of the infant, in tying and cutting the navel string, 
and in receiving or gently aiding the delivery of the after 
birth. 

Midwives should keep this division of labor into four stages 
constantly in their minds, and perfectly understand what is 
going on during ea3h, by which they will avoid all unneces- 
sary hurry and confusion, and they will expect no more in any 
one period than is intended by nature to be then performed. 

Examination of the Passage. — To perform this properly, 
and to draw from it certain conclusions in intricate cases, can 
be acquired only by attentive practice and experience, aided 
by previous anatomical knowledge of the parts. But we hope 
to be able to give a few plain directions, which may teach 
others how to judge of their progress, and to direct them in the 
conduct of a natural labor ; and also to discover those which 
are unnatural, and are likely to be difficult. It is a rule among 
physicians never to perform the operation except in the presence 
of the nurse, or some other married woman ; but with female 
midwives, this delicacy is not absolutely necessary ; still it 
is advisable that some other woman be present. The patient 
should lie on her side or back on the edge of the bed, wirh her 
knees drawn up, and a light covering should be thrown over 
her. The midwife sitting at the side of the bed, the forefinger 
anointed with lard or sweet oil, is to be carried up to the outer 
parts into which tne finger is to be cautiously introduced. The 
introduction should be made with all possible tenderness, care- 
fully avoiding all hurry, force or rudeness, by which the parts 
may be irritated or wounded ; and, above all things, take care 
not to break or burst the membranes. 

The finger will probably first reach the neck of the womb, 
covering the head of the child, and pressing down into the 
vagina, or birth passage; passing the finger toward the back- 
bone, and upward, the mouth of the womb will generally be 
found (in the beginning of labor) far back and high up, very 
different in different women. In some, hard and irregular ; 
in others, thick, soft, and smooth, a little open, and beginning 
to discharge a thick mucus ; whilst in some few it is worn quite 
away, although still close shut. The examination is to be com- 
menced a little before the time that a pain is expected, and 
should be continued during the pain, and until it ceases, so that 
the effect of the pains upon the internal orifice or opening may 
be noticed ; and having the finger introduced, continue it untu 
satisfied of all that is desired, or can then be discovered. 

If the mouth of the womb be pressed down tight, and begins 
to open during the pain ; if this general tightness relax during 



184 Midwifery. 

the intermission, and especially if those parts remain soft and 
slippery, and a thick mucus, with or without some tinge of blood, 
begin to ooze from them, we conclude the labor to be actually 
begun. But if, on the contrary, we discover no extraordinary 
pressure, and the mouth of the womb be neither opened 
during the pain nor relaxed again as the pain goes off, we may 
conclude the present pains to be false — that labor has not yet 
begun. 

False Pains — Frequently resemble true labor-pains so ex- 
actly as to be mistaken for them, particularly by young women 
with their first child. But they are carefully to be distin- 
guished from true labor, or the mistake may lead to error 
and mismanagement. If it is ascertained that the pains are 
false, the woman, if she be feverish, with a full pulse, and hot 
skin, should be put to rest in bed ; if costive, the bowels should 
be moved by a gentle purgative, assisted by an injection u* 
the bowels, of warm water, and perspiration to be promote*! 
by drinking frequent draughts of weak tea. By such means 
false pains will generally be removed ; but if they still con- 
tinue after the fever has been moderated, and the bo we la 
opened, a teaspoonful of paregoric, or twenty drops of lauda- 
num given (and repeated if necessary, in two hours), assisted 
by rest and quiet, will seldom fail in suppressing them. 

First Signs of Labor. — Some days before the time, a wo- 
man begins to feel the symptoms of her approaching labor, she 
moves with difficulty, and frequently complains of restlessness 
and pain in her back and loins. As the period approaches she 
becomes smaller around the abdomen. Sometimes a diarrhea 
comes on, but generally she is rather costive ; she perceives 
some enlargement, relaxation, and a degree of forcing down of 
the external parts, and frequently a glairy mucus tinged with 
blood, is discharged ; but this latter symptom more frequently 
comes on after labor has actually begun. 

It is often the case that the anxiety, restlessness and uneasi- 
ness of this period prompt many women to wish it over ; and 
some are so imprudent as to attempt to shorten it by rough 
exercise, with a view to bring on their labor. But no conduct 
can be more faulty or absurd ; at any rate, they increase the 
present uneasiness, and should they succeed in their attempts 
to precipitate their labor, before nature is properly prepared 
for it, they will unquestionably render it more tedious, more 
painful, and more difficult. On the contrary, let them, accord- 
ing to the dictates of nature, give themselves more rest that, 
usual attend carefully to the state of their bowels, keeping 
them freely open. 

The subsidence of the belly which denotes the approach of 



Midwifery. 185 

labor, is caused by the womb beginning to contract at the up- 
per part, and proves, not only tnat the womb lias begun to 
act, but, that it is prepared to act in a favorable manner. In 
like manner, the discharge of mucus, and the relaxation and 
distension of the external parts, show that they are prepared 
to dilate. The difficulty in urinating is owing to the pressure 
of the child's head upon the neck of the bladder ; the constant 
desire to pass the urine, to the same pressure upon the body 
of the bladder ; both are favorable symptoms, and indicate a 
natural presentation of the child. 

Diarrhea is sometimes a sign of labor, which, if moderate, 
is always favorable and should not be interfered with ; if pro- 
fuse, a few drops of laudanum will generally check it. 

Costiveness, when it exists, is not only distressing for the 
present, by increasing heat, restlessness and pain, but may 
become very inconvenient during labor. If, therefore, a preg- 
nant woman has neglected to pay attention to this circum- 
stance before, she must now take care to remove it, by mild 
laxatives, or rather by repeated injections of warm water, 
which is the best mode at this late period, when all active medi- 
cines are improper. 

FiKbT Stage or Labor. — The first stage of natural labor, 
which is occupied in opening the internal orifice of the womb, 
frequently commences with a slight shivering, which, when 
connected with regular pains, is rather a favorable symptom ; 
but, if succeeded by fever, is unfavorable. But most common- 
ly, labor begins with pain in the back and loins, stretching 
from thence across the belly, and ending at the upper part of 
the thighs. It soon leaves the woman free, and returns again pe- 
riodically, at longer or shorter intervals. These pains, at first, 
are slight, and return at long intervals ; but soon the intervals 
grow shorter, and the pains become exceedingly sharp and cut- 
ting, and, at the same time, the mucus discharge from the outer 
parts is generally discolored by some blood ; after which, the 
very sharp and cutting sensation commonly abates ; and, 
although the pains grow stronger, return at shorter intervals, 
and the pressing down increases, they become less distressing, 
and are borne with less impatience. 

On making an examination at this period, (which should be 
very seldom, and always with the greatest caution, for fear of 
breaking the membranes,) this variety of the severity and 
sharpness of the pains, will be found connected with the situa- 
tion, and to depend on the state of the mouth of the womb. 
At first, it is found far back, and high up, with edges more 
thick and hard, and the opening small and hardly perceptible; 



186 Midwifery. 

as the pains continue, the internal orifice or mouth of ths 
womb descends, and comes forward ; the edges become tliia 
and soft, the opening enlarges, and after some time, will admit 
the finger — a small bag is then felt within, which, during the 
pain, tightens, and is distended, but, as the pain goes off, be- 
'comes loose. As the internal orifice enlarges, this bag passes 
through, and assists in dilating it, until the thick edges of the 
©rifiee, or mouth, being entirely obliterated, the membraneous 
bag, no longer supported by them, gives way, and the waters 
are discharged. Sickness and vomiting are frequent and salu- 
tary symptoms of this stage of labor, the nausea contributes to 
the entire relaxation of the whole system, and the retching 
adds somewhat to the dilating effects of the pains. 

The duration of this first stage of labor is very different in 
different women, and in the same women at different labors— 
but, in general, it requires more time with the first child than 
with those which follow — and in all women, it commonly takes 
up more time than any other stage of labor. If the mem- 
branes burst early, before the labor begins, or very soon after, 
then, the mouth of the womb, requiring to be dilated by the 
child's head, the pains in the back are more grinding, and the 
dilation or opening, in all respects, more tedious and more 
painful, but still requires only more time, patience, and cau- 
tion. And, if the neck of the womb descends very low, before 
the mouth begins to dilate, as it sometimes does, it likewise 
tends to protract this stage of labor. 

Bear in mind, that in this stage, no skill or art of the mid- 
wife, no exertion of the woman, can in the least contribute 
either to lessen the severity of the pains or shorten their dura- 
tion. They are intended by nature to accomplish a necessary 
and important object, that is, the complete opening of the in- 
ternal orifice of the womb, which, from a hard ring of some 
considerable thickness, and generally close shut, is to be soft- 
ened, relaxed, and worn away, until it is entirely obliterated, 
and so astonishingly enlarged, as to permit t'he child to past 
through. 

Nevertheless, if we can during this stage neither lessen the 
woman's pain, nor shorten its duration ; and, although we are 
forbid interfering in any manner with the progress of natural 
labor, yet the presence of a midwife, or such other woman as 
may be selected to officiate, is far from being useless, but 18 
very necessary. They should inquire into the state of th« 
patient's bowels, and, unless they be in a laxative state, ad- 
minister an injection ; indeed, whenever there is time for it, it 
m a good rule always to do this, as by its effects the injection 



Midwifery. 187 

has in all respects a tendency to promote and render labor easy, 
and is particularly useful in the case of a first child. She 
must likewise pay attention to the evacuation of the urine— 
diroct her patient to discharge it frequently, and if she fail in 
one posture to try another ; sitting over warm water, or lying 
on either side, on her back with her hips raised ; on her knees 
with the head low. Should all these efforts fail, the midwife 
should, while the patient is lying on her back, her head and 
shoulders lower than her hips, and during the remission of 
pain, introduce a finger under the pubes, or front part, and 
endeavor to raise the child's head a little from its pressure on 
the neck of the bladder ; and while so raised let the patient 
make effort to void urine ; and if notwithstanding these efforts, 
a total suppression should take place, she must be relieved 
early in labor by the catheter. Tor, as labor advances, the 
difficulty of discharging the urine will increase — -the pain of 
the distended bladder may become so great-, as to intercept 
and suspend those of labor — and the bladder being over dis- 
tended, may lose its power of contracting ever after ; and may 
inflame, and bring on fever, convulsions, mortification and 
death. Such are the evils which may follow neglect — but 
which can very generally be avoided by proper care. But, 
we would here remark, that the above suppression must not be 
mistaken and confounded with that suppression, which takes 

Elace towards the conclusion of the labor, when the child shall 
ave descended low down, the pains being forcing with con- 
eider able effort, and there is reason to hope that the labor will 
goon be completed — this latter suppression will soon be reliev- 
ed by delivery. 

After such attentions as before mentioned, the labor is to be 
suffered to go on without any interference — the pains continu- 
ing gradually to open the internal orifice of the womb, and 
force the membranes through it, in the form of a purse, which, 
acting as a soft wedge, contributes in the easiest way to its 
further dilation. Of tiiis, the midwife may now and then as- 
sure herself by examination. Although the finger may be 
introduced on the accession of a pain, no accurate examination 
must be made until it remits, lest the membranes should be 
burst, and the waters let out before the internal orifice be fully 
dilated, which accident always protracts labor, and renders it 
more painful and more difficult. Do not make too frequent 
examination ; it is injurious, by removing the mucus from the 
«oft parts, intended by nature for lubricating them, and causes 
irritation. 
The abominable practice of stretching the soft parts of the 



188 Midwifery, 

mother by the midwife, under the idea of making room for the 
child to pass, is preposterous and cruel. It is impossible 
to censure this idle, indecent, and dangerous practice too se« 
verelj ; it is always wrong, nor can there be any one period in 
any labor, the most easy and natural, the most tedious and dif- 
ficult, in which it can be of the least use, and in which it will 
not unavoidably do great mischief. 

Therefore, leaving nature to her own unassisted and undis- 
turbed efforts, the midwife is to encourage her patient, by 
appearing perfectly calm and easy herself, without hurry 01 
assumed importance — by assuring her, that as far as can now 
be discovered, all matters are natural ; by encouraging cheer- 
ful conversation with those around, permitting her to walk 
about the chamber, or from room to room, to sit or lie down, 
as she finds most agreeable, and if she can, to sleep between 
the pains — but although inclined to it, she should not lie 
constant, until the mouth of the womb shall be completely 
opened. The midwife should excite the hopes and confidence 
of the patient, by manifesting her own ease and firm belief in 
the natural progress and happy termination of the labor ; hope 
and confidence will very much tend to give regularity and 
strength to the pains, whilst on the contrary, fear and despon- 
dency will tend to disturb and protract the labor. Let there 
be no " hobgoblin" stories, " ghost tales," nor superstitious 
nonsense in the room of a woman in confinement. 

Partaking of food at the proper time during labor, is allow- 
able, but it should always be light and sparing. 

There is great impropriety in directing the patient, at this 
period, to assist her pains, as it is called, by holding her breath, 
and exerting her strength ; by forcing, straining, and bearing 
down — which inevitably will exhaust and waste her strength , 
now in the beginning of labor, which may be necessary for her 
support at the conclusion. Young women, with their first la- 
bor, are most apt, from impatience, to be guilty of this error, 
by which they necessarily overheat themselves, and may bring 
on a fever ; it may likewise occasion a premature bursting ol 
the membranes. 

A still more dangerous practice is that of giving strong 
aromatic teas, cordial, and spiritous liquors, with a view to 
strengthen the pains ; but which can only increase the resist- 
ance to their proper effect, by heatiug the patient, bringing on 
fever, and checking the natural secretions ; on the contrary, 
let the patient's food, if she take any, consist of cooling fruits, 
thin gruel, and weak broths ; and her drink, lemonade, apple 
water, weak tea, or what is still better, fresh water. In sum 



Midwifery. 189 

mer, let her chamber be kept cool bj open doors and win- 
dows : and in winter, comfortable but n^t too warm. 

The patient should be strongly impressed with the fact, that 
the best state of mind she can be in at the time of labor, if 
that of submission to the necessities of her situation ; that those 
who are most patie?it, actually suffer the least — that, if they 
tre resigned to their pains, it is impossible for them to do 
wrong — and that attention is far more frequently required to 
prevent hurry, than to forward a labor. Instead, therefore, of 
aespairing, and thinking they are abandoned in the hour of 
their distiess, all women should believe, and hnd comfort in 
the reflection, that they are at those times under the peculiar 
care of Providence — and that their safety in child-birth is en- 
sured by more numerous and powerful resources than under 
any other circumstances, though to appearances less dan- 
gerous. 

The practice of gathering many attendants, is certainly very 
improper, and is one from which serious inconvenience has re- 
sulted ; yet, the presence of a few elderly women is of very 
great service. If their attendance is requested, it becomes 
them to consider for what purpose — most assuredly, to assist 
in an important business, in which the welfare of one of their 
sex is at stake ; and not by indulging in idle gossip, and mag- 
nified reports and misrepresentations of unfortunate cases, and 
perhaps such as never occurred, to overwhelm the sick wo- 
men in gloom, fear, and despondency. All questioning and 
unnecessary inquiry, all smothered and mysterious conversa- 
tions, should be carefully abstained from, as highly injurious. 
On the other hand, all levity of conduct, and unfeeling mirth, 
should be as strictly guarded against, as having an equally in- 
jurious tendency, by creating excitement in the mind of the 
patient, owing to its annoyance. 

The first stage of labor is thus to be passed, now and the** 
cautiously examining its progress ; in doing which, when the 
internal orifice is sufficiently open to admit the finger, the head 
of the child may frequently be felt and distinguished by iti 
regular shape, smoothness, and hardness, through the mem- 
branes ; and may be made another source of consolation and 
encouragement to the patient, by assuring her of it. But w 
must be cautious how we predict a speedy termination of tnt 
tabor, for many circumstances which we can not at the time 
discover, may concur to deceive us, and nothing will tend more 
to render the patient anxious, and robs us of her confidence, 
than disappointment in this respect. 
It will now be proper to arrange the patient's dress and bM 



190 Midwifery 

A flannel petticoat, and short-gown, with the shift turned up o?oi 
the hips, so as to preserve it ary ; but any dress will do if it be 
not too cumbersome, and the under side of which can be dou- 
bled up under her hips as she lies on the bed. On the middle 
of the bed lay a quilt or blanket, four double ; over this the 
sheet, doubled back toward the head of the bed. Near the 
foot of the bed, on that place where the patient wilL lie when 
ghe is being delivered, put down upon the under bed a folded 
sheet with one end hanging over, so that the midwife may take 
the edge of it on her lap ; over this latter sheet, a blanket or 
quilt doubled and redoubled, but not hanging over. A piece 
of thin oil-cloth under all these, is also advisable, to keep all 
moisture, etc., from getting on the bed. This arrangement 
will be found very convenient during labor, and by means of 
which the patient, after she has been delivered, may be made 
dry and. comfortable with very little fatigue — it being a matter 
of very considerable importance to have the woman put to bed 
ivy. If another bed is intended for her lying-in, it should be 
prepared as was first above directed, but without the sheet 
being reflected upward ; and after delivery, she is to be lifted 
from one to the other, without being suffered to rise up. 

Second Stage of Labor. — This stage of labor commences 
with a full and complete dilatation or opening of the internal 
orifice of the womb, and is ended when the child's head has 
sunk through the brim of the pelvis (or bones) so low as to begin 
to rest upon and distend the soft parts of the mother. These cir- 
cumstances can be certainly known only by examination ; but 
there is, likewise, a remarkable change in the patient's manner 
of expressing them. Whilst the internal orifice of the womb 
is opening, the pains are cutting, sharp, and grinding — the 

Eatient is restless, bears them with impatience, and expresses 
er sense of them by sharp and shrill cries ; but when this is 
accomplished, or nearly so, the pains become more supportable, 
and the patient finds herself instinctively called upon to make 
gome voluntary exertion. She lies quiet, holds her breath, and 
expresses her sense of pain in a grave tone of voice, or fre- 
quently bears them in silence. 

About the commencement of this stage of labor, as pre- 
viously stated, the membranes frequently break, and the 
water is discharged. This in well-formed women, especially 
such as have borne several children, is generally a period of 
gome little alarm ; as, when the child is small, the head falls 
almost by its own gravity through the pelvis, and delivery 
gucceeds immediately ; for this circumstance the midwife 
should always be prepared; and for some time previous at 



Midwifery. 191 

.east, the patient shou d be laid on her bed, that at all events, 
the necessary assistance may be afforded, and that no accident 
may happen from hurry, confusion, or mismanagement. But 
more frequently this stage of labor takes up a longer time ; 
and although in a well-formed woman and a small child, it 
may end in a few minutes after the perfect opening of the in- 
ternal orifice, in others it may sometimes require many hours. 

Of course the duration of this stage of labor depends on the 
proportion which exists between the size of the child's head 
and the openings of the bones, or upon some irregularity in its 
shape, or some awkwardness in the presentation of the head- 
circumstances which nature, when left to herself most fre- 
quently will vary, so as wonderfully to adapt one to the other 
in every stage and progress of the labor. The imperfect hard- 
ening of the bones in the child, and the loose manner in which 
they are connected by membranes, is the provision which na- 
ture has made for overcoming these difficulties. Where the 
head is large and the pelvis or bony passage narrow, the bones 
ride over one another as the head is forced through the brim, 
and the shape becomes more oval and pointed, entering the 
brim of the pelvis or outer bony passage, with one ear towards 
the lowest portion of the back-bone, and the other toward the 
pubes or front part, that is, with the narrowest part of the head 
to the narrowest part of the mother ; it turns as it descends, 
where it finds most room, until the face is brought into the hoi- 
ow of the sacrum, or lower part of the back-bone, and the ven 
tex, or smallest and most pointed part of the head, to the ex 
ternal orifice. 

Our great care in this stage of labor, especially when it 
proves tedious, is to regulate our patient's conduct, to soothe 
her sufferings, to calm her fears, and above all things, make 
her to avoid fatigue by over exertion. Although the woman 
feels some disposition to voluntary efforts, she is not to be en- 
couraged to exert herself during her pains, more than she can 
veil avoid. 

The bursting of the membranes, likewise, is a circumstance 
of great uncertainty : it most frequently happens at the end of 
the first stage, or during the second stage ; but it sometimes 
occurs with the first pain, sometimes many days, or even weeks 
before the commencement of labor — at other times, after hav- 
«*lg, in the form of a distended sack, contributed to dilate the 
internal orifice of the womb, they continue in the same man- 
ner to dilate the vagina, or canal leading to the outer parts, and 
external orifice ; and now and then are expelled entire, cover- 
ing the child's head with the placenta (afterbirth), and water 



192 Midwifery. 

but this is a circumstance by no means to be wished, and 
ought not to be permitted, as it may be followed by a dan 
gerous flooding, or by an inversion of the womb. Whenever 
therefore, the bag appears at the external parts, it ought to be 
ruptured, and the water let out, which is now easily done by 
keeping the finger hard against them, or by placing the end 
of the finger firmly on the presenting part of the child covered 
by the membranes, in the absence of the pain, and keeping it 
in contact during the succeeding pain, which will seldom fail to 
rupture the membranes ; for that point on which the finger i« 
kept will have to bear the whole of the pressure of the water 
urged upon it by the effort of the womb. During this stage 
of labor women are less inclined to move than during the first 
stage ; still they are not to be confined to one posture, but in- 
dulged, and permitted to rise from the bed, to walk about, and 
endure some pains by leaning over the back of a chair, sup- 
ported by their friends, or kneeling at the side of the bed. 

It is just at this time that the impatience and apprehensions 
of the patient are frequently much excited, the pains return at 
short intervals, and are strong and bearing ; she longs and 
hopes, and strives for a speedy termination, and it require? 
much prudence and no little management to check her im- 
patience, at the same time that we support her hopes. She 
may be assured of her safety, but must be informed that much 
of that will depend upon her proper conduct, and longer time, 
and above all things, the midwife must not appear too busy i» 
any apparent or real efforts to shorten it. 

Third Stage of Labor. — This begins at the time when th^ 
head of the child, having sunk through the pelvis, or bones, 
begins to rest on, and distends the soft parts of the mother, at 
which time the vertex, or central top of the head, presents a* 
the external parts, and the forehead and face occupy the hol- 
low of the sacrum, or curved lower part of the back-bone, 
and continues until the perineum, or space between the pri- 
vates and the fundament, being stretched and distended inte 
the form of a large protuberant tumor, the external parts is so 
far dilated as to suffer the head and body of the child to pas* 
through without injury. The pains during this period, whilst 
the perineum and soft parts are undergoing so great distension, 
become more severe, and at last, when the child's head is pass- 
ing the external parts, are most exquisite. But they alwaye 
are least when the labor has been suffered to go on from the 
first with little or no interference, and much more excruciat- 
ing and dangerous, when these tender parts have been fretted 
and inflamed by improper conduct at the beginning. 



Midwifery. 193 

The part which is most apt to suffer during this period, is 
the perineum, or space between the privates and the funda 
merit, which, from the extent of one inch, or an inch and a 
half, and thickness of the hand, is stretched to that of four or 
five inches, and reduced to the thinness of paper, so that in the 
most natural and well-conducted labor, it will sometimes give 
way at this extremely thin edge. The perineum and adjoin- 
ing parts are relaxed, and prepared for so great a change by 
Ihe secretion jf a large quantity of mucus, by which the parts 
are softened, and a disposition to yield and stretch, is given to 
them, at the same time that they are lubricated by it, so as to 
suffer the child to slide through them ; and whenever there 
happens to be a deficiency of this mucus, or when, by impro- 
per handling, it has been rubbed off, and its secretion checked, 
or when a violent and sudden labor does not allow sufficient 
time for this secretion to take place and give to those parts a 
proper disposition to dilate, the perineum is apt to be torn, 
always an unfortunate accident, and one which, if extensive, 
subjects the woman to great misery and inconvenience during 
the rest of her life. 

It should be your great care in a natural labor, to prevent 
this, and to which attention should be directed, from the very 
commencement of labor to the complete delivery of the patient. 
With this view, avoid irritating these extremely tender parts 
by too frequent and unnecessary examination, or rude and pre- 
posterous attempts to stretch and extend them, as well as avoid 
beating the patient by improper diet, cordials, and spiritous 
liquors in the commencement. 

During this stage of labor, a woman becomes less inclined 
and less ablo to move, and the delivery may be expected to 
be accomplish sd in a short time. She is, therefore, now, or 
rather before, S she was not there already, to be laid on her 
bed in a proper posture for delivery ; that is, on the folded 
blanket or quilt, ^t the foot of the bed, on her back, her clothes 
being turned up ander her, and she laid near the edge of the 
bed, and her knees moderately drawn up and her feet sup- 
ported against the bed post, or against some person sitting oil 
the bed, taking care not to draw her legs too much up toward 
the belly, nor to separate the knees very wide ; both of which 
put the perineum on the stretch, and increase the danger of its 
being torn. 

The bed being prepared, and the woman laid on it ai 
directed, the midwife is to sit herself behind on a low chair, 
taking the end of the if >lded sheet, which had been laid across 
the bed, on hej knees j she will then find herself most ecu- 



194 Midwifery. 

veniently placed to afford every assistance. Still, howler 
she has nothing to do, and it may require some time before she 
will perceive the perineum sufficiently distended, and the ex 
ternal parts so far dilated that the crown of the child's head 
shall begin, during each pain, to protrude. She is then to take 
Into her left hand a soft linen or cotton cloth, which, being 
several times folded, and placing it over the tumor, with hei 
fingers extended, and the palm over the perineum, make a 
gentle pressure on the tumor during each pain, so as in some 
measure to retard the sudden advance of the child's head, or 
rather, to be ready to retard it, when a violent pain shall 
threaten too sudden a delivery ; for, let it again be recollected 
that in a slow labor, well managed from the beginning, where 
the soft parts are properly prepared to yield, the perineum 
never is torn, and that aU the danger of this unfortunate acci- 
dent arises from a sudden and violent labor, or one that has 
been mismanaged in the beginning, or the patient throwing 
herself beyond the reach and support of the midwife. 

Any considerable resistance is seldom necessary ; but as the 
child's head passes through the external orifice, it is always 
proper, whilst one hand is kept in the position just now de- 
scribed, to place the fingers and thumb of the other hand col- 
lected together, upon the protruding part of the child's head ; 
in this position, the midwife has it in her power to make such 
resistance with her hand as the rapidity with which it advances 
may require ; and to make it on the head, rather than on the 
perineum, the dilatation of which by too great pressure may 
be prevented, and the perineum itself bruised. Experience 
alone can teach the degree of resistance required, and until the 
midwife has acquired this experience, she must exercise her 
judgment, and be cautious not to make more than is necessary, 
for by too much, mischief may also be done, and where the 
labor has been well conducted from the beginning much ia 
seldom required. 

The direction in which the pressure on the perineum ig 
made, is likewise of some consequence ; it must not be directed 
upward and backward, but it must be directed upward and 
forward toward the pubes, or front ; by which, as the ceutrc 
of the head advances under the arch of that bone, the nape of 
the child's neck will be pressed up against it, and immediately 
relieve the perineum. "When it is perceived towards the last, 
that from early mismanagement, or from any other cause, these 
parts are not properly prepared to dilate, and there is a dry- 
ness and rigidity about them, we are directed to anoint the 
parts with hog's lard or sweet oil, once or twice, and over that } 



MidAmfery. 195 

to apply a soft flannel wrung out of warm water ; this, we have 
reason to believe, is of advantage, as it promotes the secretion 
of the mucus, and otherwise relaxes the parts. 

At this moment the sufferings are at the highest — extremely 
severe, and sometimes almost beyond endurance ; and, in hopes 
of shortening their continuance, she is often inclined, and too 
frequently called on to exert her utmost strength. Still, how- 
ever, her present safety and future comfort may very much de- 
pend upon submission, patience, and gaining a little mors 
time ; and all extraordinary exertion beyond what she is in 
gome measure compelled to make, is hazardous. Therefore, 
do not discourage her crying out, but encourage her to speak, 
by asking questions, which will check the bearing down 
efforts, and gain a little more time, which may be necessary, 
not only to the safety of the perineum, but to the preservation 
of her life. 

Just before the birth, the head is often found to advance 
during the pains, and to retire again as they remit ; and this 
alternate advancing and retiring is frequently of much conse- 
quence to the perineum, by the strength and elasticity of which 
it is generally occasioned, and which, after some little time, 
will thereby become perfectly relaxed, and easily distended. 
If, however, it should lodge upon the chin of the child, by in- 
troducing a finger within, between the pains, it may easily be 
glipped over it, and the next pain the head will generally be 
delivered ; but this must not be attempted whilst the perineum 
is tense, nor during a pain, but only when it is relaxed and 
easily distended. As the head emerges from the external parts, 
it should be received by the midwife on the extended fingers 
and palm of the hand, stretching the fingers round, so as to ex- 
amine whether the mouth and nose be covered by any of the 
membranes, or any part of the clothing, by which its breath- 
ing might be obstructed, still keeping the hand in contact with 
the perineum, and under the child's chin. 

A short respite ensues when the head is delivered ; but the 
pains soon returning, the shoulders of the child are perceived 
as they descend, to make the same turns as the head had done 
before ; and after a pain or two, they are delivered, the one 
toward the abdomen, and the other toward the back of the 
mother. While they are passing the external orifice, the same 
attention is to be paid to the perineum which the passage of 
the head rendered necessary, as the distension is ratlier greater, 
and the danger of laceration not diminished, which, in fact, 
has frequently taken place at this period, through neglect of 
the midwife, induced by the supposition that the danger wai 



196 Midwifery. 

all over as soon as the head was delivered. The next pair ad- 
vances it to the hips, so that the arms of the child are delivered 
with little or no assistance. Another short respite again take* 
place, whilst the hips of the child advance, of which one of 
two pains effect the delivery, and the birth of the child is ac- 
complished. 

In this gradual way, time is allowed for the regular con- 
tractions of the womb, from the top, around the afterbirth, 
pressing it down before it ; whereas, in a more sudden delivery, 
when the head, shoulders, and body of the child are ejected 
by a single pain, the womb may, and frequently does, contract 
from its sides, expelling the child, but retaining the afterbirth 
high up in the top. The midwife should, therefore, never, aa 
it is too frequently done, take hold of the child's head, and 
drag it forth : a most dangerous practice — generally the cause 
of severe after-pains, and frequently the cause of much worse 
consequences, as a ruptured perineum, retained afterbirth, 
flooding, inversion (turning inside out), or falling of the womb, 
by which many women have lost their lives. 

At the time of the child's emerging from the external parts, 
the extreme suffering of women will impel them to implore 
anxiously for relief; her friends also will call upon the mid- 
wife and expect her to assist in the delivery, and not unfre- 
quently medical aid is sent for at this stage when it is utterly 
impossible for the physician to arrive before the case has ter- 
minated, unless he be very convenient ; but no entreaties should 
cause the midwife to deviate from correct principles, and make 
her endeavor to hasten the expulsion of the head ; after th at 
event there is not so much inducement. Should there, how- 
ever, be a considerable interval betwixt the expulsion of the 
head and of new pains, she may press gently on the belly, or 
cause gentle pressure to be made by some assistant. Or she 
may gently insinuate the finger into the arm pit, and slightly 
pull or agitate the child, so as to excite the womb to contract 
— even this assistance is rarely required. But on no account 
is she to attempt the delivery by pulling the head. 

The birth of the child is always followed by the discharge 
of what water had been retained in the womb, frequently by 
gome clots of blood, and generally by some fresh blood flowing 
from those parts of the womb from which the afterbirth has 
been wholly, or in part detached. 

Fourth Stage of Labor. — After the child has be^n delivered 
it should be laid in an easy posture on its side, a little inclined 
towards the back, and close to the mother ; its head and bodj 
thould be covered, with its face and mouth exposed to the air, 



Midwifery. 197 

The mother at this time is generally in great heat, and wet with 
perspiration ; and in consequence of her exertions suddenly 
ceasing, and being much fatigued, she is very apt to suffer from 
% chilL often followed by disease, which, if not dangerous, will 
yet delay her recovery ; some additional covering should, there- 
fore, be carefully spread over her, without causing a current ol 
air. The doors and windows should now be shut, if the wea- 
ther be cool, and some dry clothes slipped under, should the part 
of the bed on which she is lying, be wet : whilst, however, these 
directions are being executed by the nurse and other assistants, 
our attention should be directed to the child. 

Duties relative to the child. — Our first object is to ascer- 
tain whether breathing be established. Should this be fully es- 
tablished, and the pulsation or beating in the cord have ceased, 
the midwife may at once separate it from the mother. This is 
done by applying two strings, one about two inches from the 
umbilicus or navel of the child, the other about one inch further 
and cut between them ; this should not be done under the bed- 
clothes, but uncovered, that she may see distinctly what she is 
doing, for fear of cutting some part of the child, which has 
happened with careless midwives. Sometimes a finger or a toe 
has been thus cut off. The child should not be separated from the 
mother, until the pulsation in the cord has ceased. Any strong 
piece of string, tape or ribbon, will answer, and it should be tied 
sufficiently tight to prevent the blood from escaping. But if 
the child fail to cry, or breathe freely soon after delivery, our 
attention should be directed to ascertain the cause — and to the 
use of proper means for inducing breathing. In determining 
the treatment necessary to be pursued, the first thing to be ascer- 
tained, is, whether circulation is still going on in the cord; which 
is done by squeezing it between the thumb and fingers, to see 
whether it continues to beat or pulsate. In cases in which this 
is going on, we need in general apprehend no great danger, at 
long as it continues; some cold water or spirits should be dashed 
on the child's breast; if this does not succeed, the little finger, 
surrounded by a piece of fine rag, should be made use of, to re- 
move any mucus that may have collected in the mouth or throat 
of the infant. If we have reason to infer that the impediment is 
situated in the wind-pipe, the hips and the body of the child 
should be elevated higher than the head with the mouth down 
ward, at the same time gently shaking, so as to assist the mucus in 
flowing out of the mouth. As soon as this takes place, the child 
generally cries lustily. But, should the child be still-born, and 
the pulsation in the cord have ceased, it should immediately be 
•eperated from the mother, as above directed, as no good can arise 



198 Midwifery. 

from suffering it to remain any longer in connection with hen 
In these cases, after having carefully removed any mucus that 
may have collected in the mouth or throat as formerly directed, 
we should endeavor to imitate natural breathing by placing 
the mouth immediately in contact with that of the child, and 
forcibly breathing into it, whilst, at the same time, the nostrils 
are held, to prevent the air from passing through them. Should 
we be successful in forcing air into the chest, which will be known 
by the elevation of it, and should it not 3e immediately returned, 
gentle pressure must be made upon the breast of the child, so 
as to cause its expulsion — occasionally elevating the hips and 
body to permit any mucus which may have collected in the 
throat or wind-pipe to flow out. In addition to this, warm ap- 
plications should be made, by applying heated clothes to the 
child, with gentle friction upon the chest. Should brea thing 
not be immediately established by this method of proceeding, it 
should not be at once relinquished, for in many cases, persever- 
ence in properly directed efforts will prove successful. 

After the child has been separated from the mother, accord- 
ing to the above directions, it should at once be delivered over 
to an assistant, who should proceed to wash it immediately, but 
if no such assistance be present, it may be wrapped up in a warm, 
soft cloth, (flannel is preferable,) leaving an opening, only suffi- 
cient to admit the air necessary for its breathing, and laid on its 
side in a warm place, until the mother be safely put to bed. 

The delivery of the after-birth. — This should also ba 
left to the efforts of nature, unless some deviation call for our 
interference. If the delivery has been properly conducted, the 
womb will have contracted successively, upon the body, hips and 
lower extremities of the child — so that by the time they are de- 
livered, it will be only sufficient to contain the after birth; and the 
succeeding contractions not only contribute to separate it from 
the womb, but press it out into the passage and from thence 
it is delivered, and thus prevents any serious hemorrhage. 
Some blood is generally discharged from the womb after the birth 
of the child, and always after the delivery of the after-birth. 
A small quantity, therefore, to the amount of even a pound, is 
no reason for alarm. A short interval, however, generally hap- 
pens after the birth of the child, before the contractions of the 
womb are manifested by actual pains, which time is required in 
the care of the child. 

No interfereu ce is necessary, if strong pains come on in half an 
hour. The contractions of the womb will throw the after-birth 
out of the passage, which is the very best security against either 
flooding or after-pains. But, if within that time, there he no 



Midwifery. 199 

contractile force exerted by the womb, the mid- wife should take 
the cord in the left hand, and pass a finger of the right hand up 
along the passage ; if she can, with the end of the linger, reach 
that part of the after-birth to which the cord is attached, she 
may rest satisfied that all is safe ; and that the womb has be- 
gun to contract and throw it off ; but if, on the contrary, she 
cannot reach the root of the string, the after-birth is probably 
still attached to the womb. Under these circumstances, she 
should place her open hand upon the patient's belly, and if 
she find the womb soft and resting on the lower side, she 
must take it in the hollow of her hand, and raise it towards the 
middle of the belly, press it moderately and rub the surface of 
the belly over gently, and change the patient's posture from side 
to back or from back to side ; she will then very probably so^n 
perceive the womb to contract, by its assuming the form of a 
ball of considerable firmness. She may now again take the cord 
in her left hand, putting it just so much on the stretch, as to pre- 
vent the after-birth (which descends a little during inspiration) 
from ascending again during expiration, still holding the end in 
her hand, pass the ringers of the othar hand as high as possible 
toward the root of the cord, and pull gently while at the same 
time, an assistant should make gentle pressure upon the belly 
with the open hand, by which the womb is frequently excited to 
make vigorous contractions. Whenthe after-birth shall have le- 
scended into the passage, and is somewhat protruding from the 
external parts, it is best then to leave it entirely to the expulsive 
efforts of the womb. 

The most common cause of delay in tne delivery of the after- 
birhis this want of expulsive pains; and this inaction of the 
womb is a very common consequence of fatigue after a severe or 
tedious labor, especially if mismanaged. But this weakness, so 
far from being a reason for haste and precipitancy, is a most 
powerful argument for waiting, and making no attempts to sep- 
arate and extract the after-birth; a hasty delivery of which, be- 
fore the womb has begun to contract with some degree of vigor, 
will expose the patient to great danger ot a flooding or inversion 
of the womb. Under such circumstances, therefore, our efforts 
must be directed to compose the patient's mind, and attempt to 
excite the action of the womb as previously directed. 

Great care should be taken by the mid- wife how she exerts any 
considerable force on the cord, which in some instances is small; 
in others, inserted by several branches into the after-birth, and 
easily torn from it — at all times an inconvenience, and on some 
occasions a very serious accident. Or, if the string should be so 
strong as to endure much force, more terrible accidents may foi- 



200 Midwifery. 

low; the after-birth may be torn from its attachment to the 
womb, of which a violent flooding will be the consequence, or 
the womb may be in part or wholly inverted, turned in side out 
and actually brought out of the body, which has been the unhap- 
py consequence of imprudent force applied to the cord. Let it, 
therefore, be an invariable rule, never to tighten the cord, 
and put it on the stretch, until the womb can be felt like 
a hard lump or ball under the hand applied to the woman'* 
belly; on the same principle, coughing, sneezing, or blowing into 
the hands, and every such exertion of the woman, are likewise 
improper as they tend to cause flooding. Should the after-birth 
however be retained or flooding ensue, directions for the treat- 
ment of them will be found, under those different heads when 
treating of the dangers of difficult or tedious labor. The 
after-birth being delivered, carry the finger into the passage up 
along the membranes, which are continued from the edge of thft 
after-birth, and slowly and cautiously assist them in coming 
away ; for if they are left, they cause after-pains, and in a few 
days a very offensive smell. 

Putting to bed. — The external parts should be annointed 
with lard or sweet oil, and a soft cloth applied ; and lift her to 
the upper part of the bed, having previously brought down the 
reflected part of the sheet ; while she is being lifted let soma 
assistant bring down her clothes which had been for security tuck- 
ed up over her hips ; if she has lain in a petticoat, it ought now 
to be removed, and the clothes from above supply its place. When 
laid in her place she should be cohered with bed-clothes, more 
or less, as she may be inclined to be chilly. A towel, four or 
five double, is then to be applied to the belly, and over that a 
broad bandage round the waist, is pinned so low, as to take in 
the bottom of the belly, and afford some support to its loose and 
relaxed sides, but not so tight as to give the least pain or uneasi- 
ness. The use of such a bandage is evident, but a tivistedhand- 
ker chief, applied in the form of a cord, and drawn down tight, 
as is frequently done, (to keep down the mother, as the women 
express ft,) is the very extreme of absurdity and must do harm, 
yet, when a broad bandage is skillfully applied, as here directed, 
it will be found very agreeable and very comfortable by the 
woman, and has a tendency to prevent and relieve that faintness, 
which is sometimes very alarming to women, recently deliv- 
ered. We would observe, that with regard to putting to bed,* 
if the patient be much exhausted and fainty, it had better not 
be attempted to move her before some hours, only change her 
posture so as to extend her limbs, putting dry clothes under her ; 
give her some nourishment until she is somewhat recruited. For 



Midwifery. 201 

Immediate nourishment we would advise as the best, a cup of 
coffee, with plenty of milk, and as much sugar as may be agree- 
able, or chocolate, either with a few mouthfuls of bread and 
butter, or rusk or boiled milk with some stale bread in it, yet, if 
the exhaustion be very great, a small portion of wine and water, 
or a tea-spoonful of brandy, with some fresh water, may be al- 
lowed, or panada, with the same quantity of wine or brandy in it; 
but unless the feebleness be very great, we would advise th* 
abstinence from all and every intoxicating liquor. 

After-pains. — Very few women but who will be troubled 
with after-pains, harassing them, and disturbing that repose so 
necessary to their comfort. Those pains, however, very much 
depend for their severity, upon the manner in which the after- 
birth has been delivered, yet it must be considered that they 
sometimes follow the best conducted and most natural deliveries. 
They come on soon after delivery, resembling in some manner 
those of labor, returning in paroxysms, though with longer inter- 
vals between them, throwing off during their action whatever 
lumps of blood may remain in the cavity of the womb. If these 
are in a moderate degree, and not of very frequent recurrence, 
they demand no remedy — but, more frequently, they are very 
excruciating, and therefore call for remedies. 

Opiates, are the surest means to be relied on; two tea-spoon- 
fulls of Paregoric, or twenty drops of Laudanum, with thirty of 
Sp. Camphor, or thirty drops of Laudanum by itself: either of 
these, given in fresh water, repeated in half doses for a few times 
at intervals of an hour or so, will seldom fail to give relief. — 
There will be some who cannot use Laudanum ; for such, use 
fomentations of Hops and Vinegar or Camphor to the bowels, 
occasionally, just warm enough to be agreeable. 

A horizontal position, laying down in bed. should be observed 
for nine days or more, and a low diet is always necessary. Every 
indication of pain and soreness, should be early attended to; 
directions for which will be hereafter prescribed. If the woman 
should have no evacution from her bowels within three days, one 
uhould be procured by the use of Castor Oil, Sedlitz Powders, or 
injections of warm water up the bowels And, if within ten or 
twelve hours, she passes no urine, she should be solicited to do 
go, and, if necessary, be aided by fomentation of clothes wrung 
out of warm water. The following will be found very beneficia I: 
Spirits of Nitre, four table-spoonfulls ; Laudanum, half a tea- 
Bpoonfull, forty drops of which, may be given every hour in wa- 
ter until relief be obtained: but should these also fail after a 
fair trial, recourse must be had to the catheter. 

Washing the child. — Children when bora are frequently 



202 Midwifery 

coated with a tenacious unctious substance, wnich is somewhat 
difficult to remove. It has been found by experience, that rub- 
bing the child over with hog's lard, until it becomes completely 
incorporated and mixed with this substance, and then making 
use of soft dry flannel to remove it, is the most simple, expedi- 
tious and perfect manner of getting rid of it. Afterwards, warm 
soap suds may be used. The process of washing should be per* 
formed, so as not to unnecessarily expose the child to the influ- 
ence of cold ; if in the winter it should be done near the fire. It 
may also be well enough here, to insist upon the person having 
charge of this office, to use as much despatch as is compatible 
with the proper execution of her duty, as it is to be feared, 
much injury is frequently done the child by too long exposure. 
After washing, it should be carefully dried. The highly injudici- 
ous and culpable practice which some nurses have, of using spir- 
its to bathe the body and head, especially the latter, should be 
strictly prohibited, as it tends to carry off the heat by evapora- 
tion. Be careful not to expose the child to a strong light or to 
get any soap in its -eyes. After having performed the necessary 
cleansing and washing of the child, the next thing to be at- 
tended to, is, dressing the naval. Nothing more is necessary, 
than after examining if it be properly secured, to pass the remain- 
der of the cord through a hole made in the centre of a piece of 
linen or cotton rag, with the extremity of the cord towards the 
breast, fold the cloth over it so as to envelope it, and secure it 
by a bandage about two inches broad, pinned round the belly. 
Be careful not to pin the bandage too tight. 

Dressing the child. — Let its clothes be put on loose, as every 
thing like lacing, or tight clothing, prevents the proper exercise 
of the lungs, impedes the circulation, — and sometimes entails 
impaired health, and a bad shape for life. Nothing is needed 
on the head except the weather is very cold. The rest of the 
child's clothing should consist of a shift, and a wrapper of fine 
flannel, with a diaper. All children cry when shifted and 
dressed, therefore the more short and simple the process can 
be, the better. Also, be careful of pins, always using those with 
elastic and protected points. 

First operations from the Bowels. — The bowels of all 
newly born infants are loaded with a mattter, technically called 
the meconium. It has been found, that it conduces much to 
the health and comfort of the child to carry off this substance, 
and its retention has even been known to give rise to fatal disea- 
ses. But dangerous as its presence may be, it should not lead 
to the administration of active and violent purges to remove it , 
for* there is no practice fraught with worse and more dangerous 



Midwifery. 203 

consequences than tLis. The mother's milk is the best purge foraa 
iii/ant, or a little molasses and water. If this, however, should 
not he sufficient to produce the desired effect, the child generally 
shows symptoms of being ill at ease ; will become sleepy ; fre- 
quently starting up ; moan and cry loudly. As soon as we find 
this to be the case, and especially if the stools still possess a tena- 
cious and greenish appearance, resort must be had to a tea- 
spoonful of Caster oil, administered warm, and repeated in four 
hours, should the first not produce the necessary evacuations. 
A mild injection of warm milk and water, with some molasses 
dissolved in it, will also assist much; as soon as the evacuations 
assume their proper color and consistence, which might be com- 
pared to tolerably thick mustard, all purgative medicines should 
be immediately relinquished. We have now described the process 
of an ordinary natural labor, and any woman endowed with com- 
mon understanding, may, by a careful study of these remarks, ea- 
sily qualify herself to give every necessary assistance in ordinary 
cases of natural labor, and distinguish most of those of difficult/ 
in time to have a physician sent for. 

DISEASES AFTER DELIVERY. 

Flooding.-K after the woman is put to bed, she loses to& 
much blood it will manifest itself by a faintness; it will be neces- 
sary to observe that, if she has been over heated by too much 
clothing, or the temperature of the room, this should be remedied 
jy the removal of some of the clothes, and fresh air freely ad- 
mitted, cold water should be freely and repeatedly sprinkled on 
her face, a cold hand rubbed over her belly, a towel or napkin 
several times doubled and wet with cold water applied to the 
belly confined by a broad bandage, and to be renewed if it becomes 
warm; frequent drinks of cold water must be given her; if she 
has repeated vomiting, a dose of soda powders after every motion, 
Wll have a good effect; if these should fail, and the case become 
alarming, a lump of alum, about the size and shape of a hen's 
egg, and a nick cut around the middle, so that a tape can be se- 
curely tied round it, which is then to be pushed (enclosed in the 
hand) into the womb, and \ft there for sometime; and when it 
has accomplished the restraining of the flooding, it should be s 7 owly 
withdrawn by pulling the tape. The applications of col? have 
their limits : they must be discontinued when they have x;com- 
plished the restraining of the hemorrhage ; or, if they fail, and 
are productive of continued chills, it may then be supposed 
that all the advantages to be expected from them are obtained; 
they must, therefore, then be omitted. If the system does not 
show signs of returning life, and the patient continues to become 



204 Midivifery. 

colder, and appears in imminent danger of dying, stimulant! 
are then administered in small quantities and often repeated, as 
the urgency of the symptoms may require. Wine or brandy, 
diluted with water and made warm, will answer; a julep made 
of the yolk of eggs and warm wine, or part of brandy or whisky, di- 
luted with three parts of water, sweetened with loaf sugar, flavor* 
ed with a few drops of Ess. Cinnamon, is also an excellent cordial 
If there be pain, fifty drops of Laudanum, or teaspoonful of Pa- 
regoric, may occasionally be added to the stimulents ; but the 
exhibition of these must cease as the patient shows signs of 
the return of life. Above all, she is not to be disturbed, or 
raised to an erect posture, but with perfect quiet — the small por- 
tion of life is to be carefully husbanded ; for there is often a 
power of living in a quiescent state, or when laying down, when 
the patient would be destroyed by the least exertion, or by be- 
ing raised to an erect position ; she ought, therefore, not to be 
raised or even moved, before she is quite revived ; and then, 
only with the utmost care. Persons have suddenly and unex- 
pectedly died through want of attention to this matter. And 
when immediate danger is no longer apprehended, the flooding 
ceased, it will still not be prudent to replenish the emptied ves- 
sels too hastily by high living, for, by so doing, the blood ves- 
sels may be easily again stimulated to immoderate action, and 
the hemorrhage renewed. 

Fainting. — Sometimes this comes on immediately after de- 
livery ; but, more frequently, not before an hour after. Some 
person ought, therefore, have the special observance of the pa- 
tient during that time, as the fainting may come on suddenly 
and unexpectedly ; if it be caused by flooding, the method to be 
pursued has been considered in the preceding paragraph: but if 
it proceed from other causes which we are perhaps unable satis- 
factorily to assign, a tea-spoonfull of Paregoric, two tea spoon- 
fuls of Bateman's Drops, twenty drops of Ether or Spirits oi 
Camphor, or either of these in some fresh water, together with 
fresh air, and forcibly sprinkling fresh water on the face, wilj 
generally soon be found to afford relief; frequently the fit will 
be terminated by vomiting. Fainting appears in some manner 
connected with the sudden evacuation of the contents of the 
abdomen; as a preventive from this cause, the bandage should 
be applied; this should, in all cases of fainting after delivery, 
be examined, and if it has moved, so as not to give the necessary 
support, it should be rectified and tightened. 

Inflammation and soreness of the external parts-— 
After delivery there is sometimes much inflammation and swell- 
ing of the external parts: by washing and bathing with warm 
milk and water, and annointing with fresh lard, it will in general 



Midwifery. 205 

go off in a few days; but if it continue to get worse, so as to re- 
quire attention, the parts are to be several times a day anointed 
with ±he following cerate: Beeswax 4 ounces, Lard 6 ounces, add 
to this. Sugar of Lead 20 grains, dissolved in two table spoon- 
fuls of vinegar, melted over a fire, and simmer for half an hour; 
strain, and stir until cool. If the parts be hot and tender the fol- 
lowing poultice will be found very useful: — one handfull of 
Hops with three of Wheat Bran, pour over them boiling water 
•unicient to make them into a poultice, which wrap in a piece 
of fine muslin, and apply it warm over the parts after putting 
on the above cerate. 

Milp fever. — The secretion of milk is usually accompanied 
with a slight fever, often amounting to a considerable degree of 
inflammatory action, preceded by shivering, and going off 
with perspiration; it is in general more severe, and of longer 
continuance with the first than with subsequent children. If 
properly managed, it will seldom continue longer than twenty- 
four hours: during its continuance the breasts are full, hard, and 
painful, which distinguishes this from fever. A tea-spoonful of 
Spirits of Nitre, in a gill of toast water, should be given every 
two hours; balm, sage, mint, or elder flower tea should be freely 
drank about luke-wami, and a poultice of bread and milk freely 
spread with lard and applied warm to the breasts. 

Sore Nipples. — These are the immediate result of some in- 
flammatory state of the system. The inflammation impeding the 
evacuation of the milk, the suction of the child peels the outer 
skin from the nipple, — the inner skin cracks, from which blood 
is discharged. As a means of prevention, when the important 
and highly interesting duties of a mother are about to devolve 
on her, she should, during the last two months of her preg»' 
nancy, have her nipples drawn out by some other person or by 
breast-pump — at first, very gently and but once a-day ; and, as 
she approaches towards the completion of her time, more force 
Bhould be used, (but at no time so much as to cause pain,) and 
the frequency of the operation increased to three times a day. 

After each suction the nipple should be washed with cold 
water, and exposed for a few minutes to the air. As soon as the 
mother gets settled in bed and rested, the child should be put 
to the breasts. When the nipples become sore or tender a 
Poultice of Flaxseed meal anointed with sweet oil or Lard, 
0hould be kept to the nipple all the time except when necessary 
to remove it long enough for the child to nurse. This is bettei 
than any other application. When the nipple feels tender on 
the child sucking it, the attention should immediately be di- 
rected to the state of the system ; if costiveness prevail, to hart 



206 Midwifery. 

the bowels moved; and if fever prevail either general, or locals 
the breast, then to live on low diet. Always attend to gently 
drawing out the nipple for the child before putting it to the breast, 
and immediately after the child has finished its suction, to wash 
the nipple with cool Sassafras or Sa ge Tea. By care and at- 
tention to this treatment on the occurrence of sore nipples, they 
will in general be relieved. 

Sore Breasts. — Sore nipples, and their consequent disten- 
tion from milk, are perhaps the most fruitful source of inflam- 
mation of the breast, and also the most uncontrollable kind: 
those which arise from cold or from that feverish state called 
the weed, will generally be more under the control of remedies. 
Sometimes, a chill will precede affections of the breast; at other 
times, a painful swelling, without a chill. In either case, fever 
is soon excited — pain and swelling increase rapidly. There 
are two varieties: one is confined to the cellular or spongy sub- 
stance between the skin and the breast, and is soon brought to 
an issue ; the other is within the substance of the breast, and 
is more slow in its progress, and frequently renders the breast, 
ever after, useless — which the first variety, of itself never does. 

The patient should be put to bed, and under the most rigid 
restrictions of diet — allowed no kind of animal food, nor any 
kind of spices, or stimulants ; toasted bread, and water only 
should be allowed unless the patient has been previously much 
reduced ; then bread and milk, mush and milk, tea or coffee, 
may be taken. Her drink should be water, or cool tea of tam- 
arinds, apples, cherries, peaches, or cream of In tar whey : she 
should be kept in a room not too warm, and a pv.ge of Castor 
oil, Rochelle or Epsom salts, be given so as \o open the bowels 
freely. Local bleeding, by cupping or leacbji^, on the body, 
near the circular margin of the breast, will a/jswer a good pur- 
pose. For a local application to the breawt,, take hot vulgar, 
pour it over some hops, let it stand for a few mir.ates, 
strain out the hops, soak fine linen or muslin cloths in it, and 
apply them frequently warm to the breast. They will be found 
particularly useful when the breast beco7nes much distended 
with milk, and cannot be drawn : it will diminish the secretion 
and relieve the swelling. The breast, however, should be c'/awj 
as long as it can be done, always washing the nipplt* clea* 
before the child is put to it. 

This treatment is to be continued through the whole 
eourse, until we have no more hopes of a resolution or scatter- 
ing the hardness, and suppuration or coming to a head is con- 
sidered inevitable; then the "further reduction ofthesysfcem, 
^v purgatives and low diet, will be unnecessary. At thi' 



Midwifery. 207 

*tage a plaster of honey, lard and flour, is among the best ap* 
plications. If we have reason to believe that mattei is formed, 
and is ready for its exit, then a small poultice of bread and 
milk, smeared with lard, should be applied, slightly warm, to 
that part where we think it will burst or have to be opened. 
As soon as there appears a small, elevated, soft, rather dark 
spot, which elevation is easily indented with the finger, but 
which also quickly reappears upon the withdrawal of the fingei 
and gives the sensation of having a fluid enclosed ; that should 
be punctured with a lancet, and the matter discharged. The 
bread and milk poultice should then be again applied : after 
a few days, it may be dressed with basilicon ointment, or some 
other cerate, until the part be healed. If there remain a hard 
lump in the breast, it should be rubbed with camphorated oil, 
opodeldoc, or volatile liniment, keeping the parts covered with 
fine flannel. 

Ephemeral fever, or weed. — This is a fever of common 
occurrence to lying-in women. It is usually of short duration, 
the paroxysm being completed generally within twenty-four 
hours, and always within forty-eight. It consists of a cold, 
a hot, and a sweating stage ; but if care be not taken, the 
paroxysm is apt to return, and we either have a distinct inter- 
mitting fever established, or sometimes, from the co-operation 
of additional causes, a continued and a very troublesome fever 
is produced. It is generally caused by exposure to cold, irregu- 
larities of diet, fatigue, want of rest, &c. It is ushered in by 
a shivering fit, accompanied by pains in the back. When the 
pold stage has continued for some time, the hot one commences, 
and this ends in profuse perspiration, which either carries ofl 
the disease completely, or procures great remission of the symp- 
toms. The head is usually pained, often intensely, especially 
over the eyes, in the first two stages, and in some instances ac- 
companied hj a slight delirium. The thirst is considerable, the 
stomach generally oppressed with wind, and the bowels bound. 
The pulse, until the third stage has somewhat advanced, is ex- 
tremely rapid. In the cold stage, we give frequent small quanti- 
ties of warm tea, such as Virginia snakeroot, balm, mint, or sage; 
and apply a bladder filled with warm water, or a dry warm flan- 
nel, to the stomach and back, and something warm to the feet ; 
by tais, we shorten the cold stage, and hasten on the hot stage. 
When the chilliness is gone off, and the hot stage is fully estab- 
lished, we then gradually remove the warm application and 
lessen the quantity of bed-clothes. We now also, in the placd 
of warm drink, give cooler, about lukewarm, such as toast wa- 
fer, lemonade or apple water If the heat of the body be ver/ 



208 Midwifery. 

great, and the thirst distressing, soda powders will be found to bi 
very grateful; but the water in which the powders are dissolved 
should he previously made about lukewarm: these may be repeated 
every half hour during the continuance of the hut stage. When 
we find the heat of the system considerably diminished, the pair 
and restlessness much abated, together with other symptoms of 
of perspiration about the breast, we then add some covering, and 
again resort to the free use of the teas, fresh made, and given 
warm, but not hot ; keeping the patient perfectly quiet, in a 
state of gentle perspiration, for the space of five or six hours. 
We then refrain from the use of the teas; and, when the process 
is over, the patient is to be cautiously shifted, the clothes being 
previously well dried and warmed; and, if she have an inclination, 
let her have something to eat. During the whole course of the 
paroxysm, we must carefully guard against the sudden applica- 
tion of cold — it renews the shivering and prolongs the disease; but, 
at the same time, we must also avoid too much heat. A com- 
fortahle room, with a moderate quantity of bed-clothes, is what 
we are to have for the patient. Do not give purgatives until the 
sweating stage is over, for fear of giving the patient fresh cold, 
but then a dose of Castor oil cr Epsom Salts may be given.— 
By the foregoing treatment we shall frequently be able to 
confine the disease to one paroxysm ; it however will in some 
cases return at irregular periods ; if the intermission become 
longer it is favorable, but if they become shorter it is unfavorable; 
if it does return the same treatment must again be pursued. 

Lochia and its derangements. — We mean by the termfo- 
chia those bloody discharges from the womb after delivery, 
which continue for some days, becoming greenish, and lastly 
pale, then decrease in quantity, and disappear altogether within 
a month, and often in a shorter time. The variableness of this 
evacuation should prevent it from becoming an object of very 
great solicitude; for it differs very much in different women, 
and in the same woman at different confinements. If the 
quantity discharged is small, therefore, or its entirely ceasing 
to flow at a very early period, need not create any degree of alarm, 
if the woman be, otherwise, in as good a condition as may be 
expected from her situation; and, no irritating or propelling 
medicines should be used : they cannot do any good, and may 
be productive of many evils. In those cases in which no very ob- 
vious cause can be assigned for the derangement, and which 
nevertheless appear to be producing injurious effects, some mild 
purgative should be administered, and, after its operation, some 
weak Cammomile or Sage tea : these, with occasionally sitting 
tp, will frequently restore the discharge. 



Midwifery. 209 

d WELLED OM MILK LEG OP LYWG-iy WOMEN. 

During or ai'ter confinement, women are liable to a swelling ot 
the legs, called milk leg; its first symptoms are great pain and 
difficulty in moving the leg. The disease does not appear to b* 
connected with any peeuliaiity of constitution or preceding com- 
plaint, nor the kina uf preceding labor, or on the treatment, be- 
fore or after child.- biith. It occurs at any period from the 
first or second day, to two or three weeks after delivery ; it is 
preceded by general uneasiness, lowness of spirits, slight pains 
about the womb, with a discharge from it peculiarly offensive. 
These symptoms seldom command much attention, until the 
patient is seized with pain on the inside of the limb, commonly 
about the calf of the leg, which soon extends from the heel to 
the groin, along the course of the vessels called absorbents. The 
limb soon after begins to swell : the soreness extends all over it, 
■o that it cannot bear the slightest touch, and every attempt 
to move gives exquisite pain ; the skin becomes glossy and pale, 
the countenance is expressive of great anguish and dejection, 
the pulse is quick, the heat of the skin increased, the tongue 
white, and the urine muddy. These symptoms strongly mark 
the presence of some irritating matter ; and no doubt it is in the 
womb. The prevention must depend on cleansing the birth-place, 
by injecting water so as to enter and cleanse it : also injecting 
powdered charcoal and water (one tea-spoonfull to the pint of 
cold water) up the birth-place three or four times a day. The 
cure of this complaint is often tedious ; sometimes the other leg 
takes on the disease, as the first subsides. The bowels should 
be opened by some good purgatives once in every two days 
The leg may be rubbed with a mixture in equal parts of Sweet 
oil, Laudanum, and Spirits of Camphor, frequently through 
the day, and poultices of Bread or Flaxseed meal applied du- 
ring the night to the groin and upper part of the leg. When 
the soreness has somewhat subsided, bathe the leg in a mixture 
of half a pint of Whiskey and one quart of cold water, night 
and morning, while at the same time the leg must be tightly 
bandaged, beginning at the toes and going up entirely to the 
groin, the bandaging to be renewed, night and morning, as the 
swelling decreases. Keep the affected leg elevated on pillows, 
higher than the body, and give a wine glass of Tea of Wild 
Cherry bark, Dog wood bark, or Culumbo root, before each 
meal, when the patient is getting better, 



210 Pimples or Worms in the Face. 

VARIOUS DISEASES 



FIMPLES OH WORMS IN THE FACE. 

This is an affection usually met with in young personi 
of both sexes. It is characterized by small, more or less, 
red pimples, which penetrate the tissue of the skin to a greater 
or less depth, and is slow in coming to a head. There are seve- 
ral varieties mentioned by dermatologists; acne simplex, which 
appears on the forehead, face and shoulders, the pustule in the 
form of small, hard, red elevations, inflamed at the lower portion, 
in which pus forms, which is thin and mixed with a thick seb- 
aceous (sticky) matter. They dry off, leaving a dark red rais- 
ed mark. When the pustules are mixed with a number of black 
circular points, which are the orifices of follices (or bags) filled 
frith sebaceous matter, and are often converted into pus tales, 
it is what is known as acne punctata or maggot pimple — ^orms 
in the skin. These follices are the habitation of a small parasi- 
tic insect, called Acarus folliculorum. If not attended to, they 
are liable to spread and accumulate, and disfigure the face sim- 
ilar to marks from a mild form of small pox. If let alone two 
or three weeks, the tops of the pustule become yellow, break and 
suffer a yellowish pus to escape, and, by pressure, a kind of 
" core" looking substance is forced out. It mostly appears on 
the face, but may extend to the back, and become ^v ery severe 
and troublesome. A similar trouble is often produced by the 
continued use of intoxicating drinks, and known by the name 
of " copper nose," " grog nose," " gro^-blossonu," &c. As 
this disease is usually produced by too rich food, the remedy 
consists in living on less meat and more vegetable Jood, taking 
once or twice a week a Seidlitz powder, and washing the face 
two or three times a day in Bay rum, Cologne water, or, if noth- 
ing better, common whiskey. 

SHINGLES. 

Shingles is usually situated near the waisi, surrounding 
one-half of the trunk of the body, like a zone or belt : it 
may however, extend in other directions orer the trunk; it ia 
always situated on one side, and that, generally, the right. 
The eruption of shingles is generally preceded by symptoms oj 
general indisposition, and especially by severe darting pain m 
the parts where it is about to appear. At first red patches 
ifeow themselves at the extremities of the site of future eruption, 



Small Pox. 211 

And gradually become more numerous till they form a line — up- 
on these patches, shining points form, w'viich gradually enlarge 
mto vehicles, or blisters, a little under the size of small peas, 
these vesicles containing a clear fluid, which gradually becomes 
thick and cloudy in appearance. At length in the course of eight 
or ten days, the vesicles burst, discharge and dry off in the 
form of scabs, or, it may be, in very weak subjects, leaves sores or 
ulcerations. The belief was formerly entertained among physi- 
cians, and still retains its hold of the popular mind, that if the 
belt of the eruption of shingles was continued round the body, 
so as to meet, the disease proved fatal. This is perfectly erro- 
neous. When the disease occurs in the young and robust, the 
diet must be reduced to milk and bread, or vegetables, and all 
sources of heat and excitement avoided. Five grains of blue pill at 
night, followed by a dose of senna or Seidlitz powder in the morn- 
ing, may be repeated once or twice : and, in the course of the 
disease, if there is much fever, five grains each of the carbon- 
ate and nitrate of potash, may be taken twice or three times a 
day, dissolved in half a tumblerfull of water ; or the proportion 
of carbonate of potash may be doubled, and a teaspoonful of le- 
mon-juice used to form the effervescing draught. The painful 
itching of shingles often causes much distress. It may some- 
times be allayed by simply keeping the eruption covered with a 
cloth soaked in tepid water, or by using the common lead lotion, 
(half a teaspoonfull of sugar of lead to a cup of water) in the 
same way. Pencilling the shingly eruption with a strong solu- 
tion of lunar caustic (ten grains to the ounce of water,) as re- 
commended in erysipelas, is found to relieve the severe pain. — 
Applying Tincture of Iodine with a Camel's hair brush, or soft 
linen mop, once a day, is also highly recommended by medical 
men. 

When shingles occurs in the aged and debilitated, instead of 
the diet being reduced, it requires, perhaps, to be improved ; at 
all events, the system must be sustained with nourishing 
broths, and with one grain of quinine three times a day. 

SMALL POX. 

The small pox attacks people of all ages ; but the young of 
both sexes are more liable to it than those who are much ad- 
vanced in life ; and it may prevail at all seasons of the year ; 
but in general is most prevalent in the spring and summer. It 
very seldom happens that a person is attacked a second time with 
the disease, however afterwards exposed to its infection. Tin 
disease is divided into two kinds — the distinct and confluent. 
la the distinct, the eruptions are quite separate from eachotfea^ 



212 Small Pox. 

but in the confluent kind, they run much into one another.-* 

The distinct may be distinguished from the confluent, befow 
the eruption appears, by the mildness of its attack, by the in- 
flammatory state of the fever, and by the late appearance of the 
eruption. 

The disease commences with shivering and languor, followed 
by heat, thirst, and headache; there is usually either pain or great 
oppression at the pit of the stomach, and not unfrequently 
vomiting; there is severe pain in the back or loins, and is 
children not uncommonly, and more rarely in adults, convulsions. 
On the third day after the setting in of the above symptoms, usual- 
ly toward evening, minute red spots, somewhat resembling flea 
bites, show themselves on the forehead, the neck, the wrists, 
and arms, the chest and abdomen, and finally on the extremi- 
ties : this, is the course of the eruption, but it does not reach 
the lower extremities till at least the fourth day. If the erup- 
tion on the parts first mentioned is discovered over night, by 
morning it is much more distinct, and the spots are much more 
numerous than they first appeared to be ; they are, too, slight- 
ly elevated — from this they continue enlarging ; on the third 
day after their appearance, they contain a little fluid on their 
summits, which gradually increases in quantity. Towards the 
fifth or sixth day, they contain pus or matter. About the sev- 
enth or eighth day of the eruption they begin to " crust," that 
is, to break, allowing their contents to escape, and then to har- 
den into a crust or scale. At this period of the disease, that 
of " maturation," the eighth day of the eruption, the eleventh 
of the disease, what is called the secondary fever comes on ; the 
fever, which had more or less abated after the eruption appear- 
ed, becomes again aggravated, and continues so for a few days. 
At length, if the disease has progressed favorably, toward the 
end ol the third week from the first showing of the eruption, 
some of the scabs begin to separate and fall off, leaving either a 
pit or a stain of a deep red color. 

Such are some of the most prominent characteristics of small- 
pox. 

This disease is to be treated, by avoiding every thing of a 
heating, inflammatory nature ; and by keeping the subject of it 
in a cool, quiescent state. The diet should be of the vegetable 
and mildest kind ; and the drinks of a similar kind, made agree- 
able by the addition of the most palatable acids. The bowel* 
are to be kept open by a table spoonfull of Rochelle salts, or 
Epsom salts, in a glass of cold water, once every two or three 
days, or a Seidlitz powder will answer ; and, above all, the pa 
tient is to have cool and pure air — never oppressed by clothing 



Warts. 213 

or a heated room. The temperature of the chamber should al- 
ways be such that he may experience no disagreeable degree o/ 
heat ; but rather a sensation of cold : and, except he complains 
of being chilly, no fear need be entertained of carrying the cool- 
ing regimen too far. His bed should be a mattrass covered only 
with a few bed clothes. 

But although the bowels should be kept open throughout the 
disease, when the eruption is coming out all attempts at purging 
■hould be dropped, cooling drinks, such as lemonade, toast wa- 
ter, &c. being given. If the surface is very hard and dry, spong- 
ing with tepid water is very useful and agreeable. When the 
secondary fever comes on, it may be requisite to act more freely 
on the bowels by means of the purgatives already mentioned, 
while at the same time the distressing restlessness requires opia- 
ates; twenty to forty drops of Laudanum or a tea-spoonfull or 
two of Paregoric, may be given at bed time. In some cases, if 
signs of sinking come on, with weak pulse, tardy eruptions, and 
pustules not filling, all lowering measures are to be avoided, and 
good broths, wine, wine whey, &c. administered, as the case 
may require. The principles of treatment are, in the onset 
of the disease to moderate the fever and through it the erup- 
tion, by cooling purgatives, (such as mentioned above,) when 
the eruption is coming out, to interfere but little beyond keep- 
ing the bowels easy, regulating the diet according to the strength; 
and, again, in the stage of secondary fever, to purge moderately. 

If much swelling and distress about the throat should result 
in the course of the disease, leeches ought to be applied, in num- 
ber proportioned to the age and constitution of the patient. — 
This treatment employed in a case far distant from medical aid 
might save life. To prevent being "Poc-marked" or scarred by 
the disease, keep the face, neck, hands, &c., well anointed with 
Sweet oil or Lard, until the inflammatory stage, and fever is 
passed, and guard against scratching or picking the scabs. 

WAKTS. 

These are enlargements and thickening of the different coats 
of the skin, or one part growing into or through the other, caus- 
ing the skin to break, and admitting this unnatural growth to 
protrude through. They are most common with children, and 
generally occur on the hands, sometimes on the face. In the 
latter situation they are better not interfered with. When si- 
tuated on the hands, they often disappear of themselves.— 
When their removal is desired, strong acetic acid, or very 
strong vinegar, applied every two or three days, is the best re- 
medy. Nitric acid is sometimes applied, or caustic, with tht 
■ame beneficial effect. The iuice of the green rind of the com* 



214 Corns 

mon black walnut, applied once a day for a week or two, will 
usually remove warts. When warts have a narrow neck, a horse 
hair or silk string, tied tight around them near the skin, wil] 
noon make them fall off. When a wart on the face, especially 
in those advanced in life, appears inclined to become ulcerated^ 
cr irritated, it ought not to be interfered with, but show it to a 
physician. 

CORNS. 

Tight shoes are one of the most frequent causes of corns ; the} 
are often troublesome to females and others who are particularly 
attentive to appearance, and who wish to exhibit a neat and 
small foot, by compressing it in a shoe of too narrow dimen- 
sions. 

Corns sometimes exist without giving much pain or trouble ; 
but in other cases, they give so much uneasiness, as absolutely 
to incapacitate for walking. They are made more particularly 
intolerable, by every thing that quickens the circulation, or which 
heats the feet, or causes the corn to press on the neighboring 
parts. Tight shoes, much walking, warm weather, heating li- 
quors, all tend to render the uneasiness of corns very great, and 
they are generally worse in summer than in winter ; and persona 
are frequently obliged to sit down to take off their shoes, and 
rest the foot in a horizontal posture. 

Corns may often be readily cured, by avoiding the above ex- 
citing causes, by wearing large soft shoes, adapted in form to the 
shape of the feet, and by continuing for some time at rest. It is 
useful to take a consideiable number of folds of linen, covered 
with some softening ointment, cut a hole in the middle for the 
corn to lie in, and to apply them to the foot ; and if it be on 
the sole of the foot, it may be useful to have an additional 
moveable sole, with a hole cut in it in like manner. If, along 
with this mechanical and palliative treatment, we use the fol- 
lowing method, a corn will be easily and quickly eradicated : 
it is to be touched with lunar caustic, and wrapped round with 
adhesive plaster ; and generally at the end of a fortnight, the 
dead skin will be removed, with the corn adherent to it. If the 
corn does not come away, the operation is to be repeated. Se- 
veral other remedies of the same kind are recommended, of 
which the principal are, soap plasters or mercurial plasters, or 
blistering ointment. The following plan may also be tried: 
every night and morning the foot is to be put into warm watei 
for half an hour, while there, the corn rs to be well rubbed with 
soap, All the soft white out side of the corn is afterwardi 
to he scraped off with a blunt knife, or what is better, with a 
piece of pumice-stone ; but we must not persist in this scraping, 



Barber's Itcfi. 215 

if there is pain in any part of it. This treatment is to be contin- 
ued without intermission till the corn is totally eradicated, which 
it will be in about a fortnight. Strong vinegar, applied to 
corns, after bathing in warm water, once a day, is also a good 
remedy. It is generally a difficult and painful operation to cut 
out a corn. Unless it be completely taken out, it is apt to grow 
again, and this it does faster than if it had been let alone. In 
old people, it is highly dangerous to cut a corn, as this fre 
quently excites an inflammation, and consequent mortification 
which carry off the patient unless carefully treated. 

Bunions. — This is the result ol chronic inflammation of the 
Mucous Bag (01 Bursa) which is situated over the front of the 
great toe, and is generally caused by tight shoes. It ought 
to be attended to at once ; one or two leeches, warm fomenta- 
tions of hops and hot water with vinegar and a poultice used to 
allay irritation, and the offending shoe being at once discarded. A 
wrong position of the bones at the joint is a frequent attendant, 
and, perhaps, an antecedent cause of bunion. When the disease 
is fully formed, the best plan is to avoid, by the make of the 
shoe, &e. &c. , every source of irritant pressure. [Bathing of- 
ten in Bait and water is advisable. 

BAKBEK'S ITCH. 

This is an eruption of inflamed but not very hard tubercle* 
(or pimples) appearing on the hairy parts of the face — the chin, 
upper lip and whiskers — sometimes in the eyebrows or the 
neck, and on the scalp. It usually clusters together in ir- 
regular patches, with the hair passing through the little eleva- 
ted points. The pimples are of a pale yellow color, and in a 
few days they burst ; matter then runs out forming a hard 
brownish crust, which fall off in a few days, leaving pimples of 
a purple color, which are slow in healing. 

Before the appearance of the eruption, there is heat, pain and 
a tingling sensation in the parts. 

In the treatment avoid the use of a razor altogether, live on 
a low diet, and bathe the parts in a solution of sugar of lead 
in water, [one Teaspoonfull to the half-pint of water] three or 
four times a day. Give a mild purgative of Kochelle Salts, a 
dose of Senna or a Seidlitz Powder, about twice a week. Also 
wash the parti thoroughly in soap and water twice a week. 
Also take on* gill of Tea made from Sarsaparilla root before 
each meal 



216 Inflammation on the Brain. 



INFLAMMATION OF THE BBAIN. 

Its characteristics are violent fever, severe pain in the heady 
redness of the face and eyes, great intolerance of light and 
sound, watchfulness, and delirium. It is usually preceded hy 
long continued watching, pains in the neck and crown of the 
head, defect of memory, diminution of urine, and irregular 
pulse. As the disease advances, the eyes sparkle greatly, there 
is ferocity in the countenance, restlessness, deafness, ravings, 
and increased pulsation in the arteries of the neck and temples. 
The tongue is dry and of a yellow or black color, the face of a 
deep red, and the pulse becomes small, quick and hard. It is 
always a most alarming disease, and often terminates fatally 
about the third or seventh day. It is produced by all causes 
which tend to excite apoplexy or fullness of the blood vessels of 
the head, — such as exposure to the hot sun, &c. 

The patient should be bled from the arm freely ; and it ought 
to be done, if practicable, while he is sitting up. Bleeding by 
cupping the temples, and by the application of several leeches, 
should not be neglected if the symptoms are violent. Cold ap- 
plications of ice, or iced water to the head are to be made and 
renewed frequently. Powerful purgatives are to be adminis- 
tered ; \<J alap and Cream Tartar, of each one or two tea- 
spoonsfull, in a gill of cold water,) and injections of ten or 
fifteen grains of tarta" emetic in half-pint of warm water should 
be given daily so Long as the symptoms continue violent. The 
patient's head snould be kept as elevated as possible, to lessen 
the determination of blood to it : and the same effect will be 
produced by partially scalding the feet, or by blistering the 
arms and legs — but these are only to be applied after the vio- 
lent symptoms are reduced. When the fever subsides, and the 
mind returns to reason, it will be very necessary to observe the 
utmost caution respecting all exciting causes : as when the in- 
flammation has once been excited, slight causes bring it on 
again. 

The diet and drinks are to be of the mildest kind. Light 
should be excluded, and indeed every thing which can excite 
the system, particularly a hot room and foul air. A shower 
bath, or cold water poured on the head, every morning, after 
the patient's recovery, will go far to prevent a return of the di- 
sease. The bowels should be kept open, by all means, to pre 
vent a termination of blood to the head. 



Delirium Tremens. 217 



DELIRIUM TREMENS. 



Usually this disease is the result of the excessive and contin- 
ued use of intoxicating liquors, though it may also be produced 
by opium. The first symptom of this disease is a state of rest- 
less irritation, and if the exciting cause be continued, sleepless- 
ness follows; there is no rest, and if there is any approach to 
sleep, it is haunted by dreams and imaginary figures that ex- 
cite the greatest dread. The nature of the disease is, unhappi- 
ly, in almost all cases too palpable, from its exciting cause. It 
is an exhausted condition of the brain and nervous system ; 
and the great effort must be to alleviate this exhaustion, 
which is too great even for sleep. Opium is the remedy among 
others, and must be given in full doses. A medical man, will, 
of course, give it more freely at once than another person ; but in 
a confirmed case of delirium tremens, thirty drops of laudanum, 
should be given at once, and ten drops every hour afterward, 
until sleep has been procured. Often it happens that the stom- 
ach is in so irritable a condition that it will retain neither food 
nor medicine ; in such a case the opium is better given solid, in 
the form of pill, one grain and a half at first, and half a 
grain repeated at hour intervals, if requisite. If the stomach 
tg still irritable, a drop of creasote, in a little spirit and water, 
may be given, and a mustard-plaster applied to the pit of the 
stomach. In cases of delirium tremens, the liver is more or less 
affected add a purgative with opium had better be given. Five 
grains of powdered opium, ten grains of calomel and twenty of 
compound colocynth pill, are to be compounded together and 
divided into twelve pills ; of these, two or three should be given 
for the first dose, and one at intervals of an hour between each, 
till six have been given. Under this treatment, after sleep has 
continued for some time, the bowels are generally acted upon, 
with immense discharge of dark, black-looking bile, much to 
the relief of the patient. After this, the remaining pills may be 
given, two every night, and castor-oil in the morning, if re- 
quired ; five, ten, or fifteen-drop doses of laudanum, or two 
teaspoonful doses of paregoric, being given, if the nervous irri- 
tation is unsubdued, or threatens to return. After the nervous 
irritation has tolerably well subsided, the next object must be 
to restore the tone of the stomach. Eight-grain doses of the 
carbonates of soda or potash combined with a bitter tonic, as 
columbo, gentian, or chamomile tea, may be given for this pur- 
pose, every eight hours ; or one grain of quinine every tnree 
hours in water will be found useful 



218 Apoplexy or Apoplectic Fits. 

During the whole treatment, it has been customary to allow 
the unfortunate subject of the disease a certain regulated por- 
tion of alcoholic stimulant, such as brandy and water, in some 
degree proportioned to the previous habits ; but it is much the 
better way to give one grain of quinine every two or three 
hours, and, as soon as the stomach will bear it, the nourishment 
of strong meat-broths, yolk of raw egg } beat up with boiling 
water and lemonade should be given. If the tongue is very 
red at the tip, and if the pit of the stomach is very tender, 
milk should be substituted for the above ; fifteen drops of the 
solution of carbonate of potash, or one or two tablespoonfuls of 
fluid magnesia or of lime-water, may be added to the milk with 
advantage. In cases of persistent sickness, soda water, and ice 
given in small fragments, frequently repeated, are often useful. 
The reception of nourishment by the system is of the highest 
importance in this disease : so much indeed, is this the case tha.t 
as long as a man continues to take food freely, he is not likely 
to become the subject of delirium tremens. One point never to 
be lost sight of in this disease, is that the stomach must not 
become empty — even cold water, to keep down thirst should t<e 
given if food will not agree with the stomach — mustard-plaster 
to the spine and stomach are often of great advantage. 

APOPLEXY OR APOPLECTIC FITS. 

This is characterized by a sudden diminution of all the senses, 
and the patient falls down. The heart and arteries — unlike i a 
fainting, continue to perform their functions. The pecuLLai 
breathing and profound apparent sleep, distinguish it from an 
attack of palsy : and the absence of convulsions makes the 
difference between it and Epileptic Fits. 

It chiefly attacks in advanced life and those of short necks 
and large heads — of full habit of body, free eaters, and great 
drinkers of ardent spirits. The immediate cause of these fits, 
is a compression of the brain : often occasioned by the bursting 
of a blood vessel within ; sometimes from the sympathy of the 
brain with the stomach — as in case of persons drunk or under the 
operation of opium or other poisons. It is sometimes preceded 
by giddiness, pain in the head, drowsiness, loss of memory, and 
faltering of the voice : though frequently it occurs suddenly, the 
person falling down without the least warning. 

In cases of apoplexy, the person should have the head eleva- 
ted : and ice applied to it, or cold water, applied by means of 
folded cloths and frequently renewed and free air admitted : all 
bandages or any thing compressing, particularly around the 
neck — should be removed. In persons of full habit, they 



Palsy. 219 

shouJd i)u8 a»iitly be bled freely : particularly from the templet 
by cupping and leeches : and it is to be repeated according to 
circumstances. They should be cupped over the head — and in- 
deed the more they are cupped the better. A large blister should 
be applied to the neck and shoulders. An injection of one table* 
spoonful of Epsom Salts dissolved in a pint of lukewarm water, 
with three grains of tartar emetic, should be given. Emetic or 
vomits of ipecac after oiher evacuations have been found ser- 
viceable. Mustard, or water nearly scalding hot, should be ap- 
plied to the feet, to rouse the system. All who have reason to 
apprehend this dreadful disease, should live very low, on a 
vegetable diet, lead a very industrious life, and cause the re- 
turn of any suppressed evacuation or renewal of sores which 
have been^healed. The bowels, by all means, must be kept 
open, and the head bathed in cold water by means of pouring, 
or a shower bath, every morning, and never let the hair grow 
long.' 

PARALYSIS, OIL JPALST. 

This is produced by the same causes which produce 
apoplexy : by suppression of evacuations : by constant hand- 
ling of lead and inhaling the fumes of poisonous metals : and 
by sedentary and luxurious living. 

When it takes place in persons of full habits, as in apoplexy, 
free evacuations by local bleeding, with cupping and leeches to 
the temples, and purges of castor oil, salts, seidlitz powders, or 
some good purgative pill are necessary. Electricity and galvan- 
ism have proved serviceable in chronic cases. When the di- 
sease affects several different parts of the body, it is customary 
to use stimulants internally, and externally to the affected part. 
Those most used are mustard, horse-radish, garlic, hartshorn, 
ether, and oil of turpentine, in their ordinary doses, and to be 
frequently changed the one for the other. The parts affected 
with the palsy may be rubbed with the volatile linament, (a 
mixture of hartshorn and sweet oil,) oils of turpentine, and 
sassafras, red pepper, and Spanish flies in spirit, powdered mus- 
tard, in short, anything may be used that will irritate the skin. 
In cases attended with loss of appetite and great weakness, give 
a tea made of wild cherry bark, columbo root, gentian root, or 
boneset, (cold,) three times a day. 

Palsy of the lower extremities frequently arises from a di- 
sease in the backbone : and the most successful treatment, is to 
keep issues or blisters constantly discharging from the surface 
of the pait where the disease commences. Children are most 
subject to this disease, Sometimes it comes on suddenly, and 



220 Sun Stroke. 

at others is preceded by a sense of feebleness, languor, and 
numbness in the extremities— occasional stumbling, and drag- 
ging the legs, instead of lifting them properly. If parents 
would early pay attention to such symptoms in their children, 
and have blisters applied at once to the back bone, where there 
seems on feeling to be a little tenderness, they would save many 
children from deformity for life. However, in many cases, it is 
caused in children by worms, colds, &c., and in such cases can 
be removed by a few doses of castor oil, and giving the child 
some warm boneset tea, to make it sweat freely — taking care 
that it does not take cold after it. 

Lead Palsy occurs in those who have long been exposed 
to the influence of the poison, and the majority of those attack- 
ed have suffered from lead colic. The attack is preceded by 
lassitude and a feeling of numbness, and by stiffness of the 
parts about to be affected, the loss of power gradually coming on. 
In a few cases, loss of feeling is also observed. Lead palsy is not 
confined to the hand and arm, but affects other portions of the 
body, although the former is its most frequent site. The most 
dangerous form of this disease affects the muscles of respiration, 

[breathing] which moves the ribs, and proves quickly fatal 
t is well here to give a caution to those who are employed 
amid lead or its preparations, that they should observe the ut- 
most cleanliness, especially at meals, for there is good reason 
to believe that the poison often finds its way into the system 
from carelessness on this point. 

Shaking Palsy, in one form, is generally the result of old 
age ; in another it is more traceable to direct disease of the brain 
and is very apt to occur in those who have drank freely. I\ 
comes on very insidiously, and even under the best care is a ver 
hopeless affection as regards cure. This is a different affection 
from the "mercurial tremour," with which those work in that 
metal, such as gilders, are liable to be attacked. 

SUN STROKE. 

This begins by thirst, dizziness, headache, and sometimei 
there is vomiting or difficult breathing, The symptoms, in 
fact are pretty much the same as Apoplexy : the patient should 
at once be taken into a cool shady place, and the first thing hav« 
a bucket of cold water poured slowly over his head, and, in all 
other respects treat the case the same as a case of Apoplexy, 
observing the cautions therein recommended, after the patient 
recovers, (Shower-bath to the head every day, &c.) 



Hydrophobia, or Bite of Mad Dog. 221 

UTDBOPHOBIA, OB BITE OF MAD DOG. 

Owing to the frequency of this frightful malady, we shall 
be as explicit in the description, of symptoms, &c, as possible. 

After a person has been bitten by a rabid dog, th^ 
wound neals in the same manner as an ordinary wound from 
the same cause would. After an uncertain interval of, say 
between six weeks and eighteen months — the following symp- 
toms begin to be noticeable : The patient experiences pain, or 
some uneasy or unnatural sensation, in the situation of the bite, 
ff it has healed up, the scar tingles or aches, or feels cold, or 
stiff, or numb ; sometimes it becomes visibly red, swelled, or 
purple. The pain or uneasiness extends from the sore or scar 
toward the central parts of the body. Very soon after this re- 
newal of local irritation — within a very few hours perhaps, but 
certainly within a very few days, during which the patient feels ill 
and uncomfortable — the specific constitutional symptoms begin. 
He is hurried and irritable ; speaks of pain and stiffness perhaps, 
about his neck and throat ; unexpectedly, he finds himself unable 
to swallow fluids, and every attempt to do so brings on a paroxysm 
of choking and sobbing of a very distressful kind to behold ; and 
this continues for two or three days, till the patient dies ex- 
hausted. Hydrophobia has never been cured when once the 
decided symptoms have shown themselves. 

The disease by the inoculation of which hydrophobia may be 
produced in man, is common in the dog, and it has been com- 
municated by the fox, the wolf, the jackal, and the cat. It has 
been produced by the saliva (or spittle) of the human being, 
the horse, the hen, and the duck. 

All animals are susceptible of the disease, when bitten by a 
mad dog, also fowls. The disease cannot be caused by the 
saliva of a mad dog getting on the skin, unless there be an 
abrasion, crack, pimples or sore, but when it gets on the mucus 
membrane, as of the mouth, nose, &c, it almost always pro- 
duces its peculiar effects. The scratch of a cat or dog will not 
produce the disease, only on account of those animals getting 
the saliva on their paws, which is very often the case. 

It is still more interesting to inquire whether the saliva of a 
human being laboring under hydrophobia be capable of inoc- 
ulating another human being with the same complaint ? The 
disease has undoubtedly been so produced. If this be so, the 
fact will teach us — not to desert or neglect these unhappy 
patients, but to minister to their wants with certain precautions, 
so as not to suffer their saliva to come in contact with any sore 
or abraded surface ; nor with any mucous surface. On the 



222 Hydrophobia, or Bite of Mad Dog. 

other hand, all carefulness of that kind will he unnecessary, if 
the disease cannot he propagated hy the human saliva. 

" 7s a man who has been bitten by a mad dog, and in whost 
case no precautions have been taken, a doomed man? Will he 
be sure to have the disease, and therefore die of it? By no 
means. But few upon the ivhole of those who are so bitten be- 
come affected with hydrophobia. 

When a person has been bitten hy a dog or cat suspected to be 
mad the beast ought by no means to be hilled, but to be se- 
cured and kept under surviellance, and suffered, if it should so 
happen, to die of the disease. If he do not die, in other words 
if he be really not mad, that will soon appear, and the mind ot 
patient will then be relieved from a very painful state of sus- 
pense and uncertainty, which might otherwise have haunted 
him for months or years. Should the dog die mad, the in- 
jured person will be no worse off than if the animal had been 
killed in the first instance ; nay, in one respect he will be better 
off, inasmuch as certainty of evil is preferable to perpetual and 
uneasy doubt. 

There are gross errors prevalent with regard to the signs of 
madness in the dog. The mad dog never has fits, in the 
commencement, he may have convulsive struggles when dying. 
It is a very common belief that a mad dog, like an hydrophobic 
man, will shun water ; and if he take to a river, that is thought 
to be conclusive evidence that he is not mad. But the truth 
is, that the disease in the quadruped cannot be called hy- 
drophobia; there is no dread of water, but an unquenchable 
thirst; no spasm attending the effort to swallow, but sometimes 
in dogs an inability to swallow from paralysis of the muscles 
about the jaws and throat. They will stand lap, lapping without 
getting any of the liquid down. They fly eagerly to the water ; 
and Mr. Youatt states that all other quadrupeds, with perhaps 
an occasional exception in the horse, drink with ease and with 
increased avidity. 

There is another superstitious opinion not at all uncommon, 
riz. that healthy dogs recognize one that is mad, and f'*tr him 
And run away from his presence. This is quite unfounded. 
Equally mistaken are the notions that the mad dog exhales a 
peculiar and offensive smell, and that he may be known by his 
running with his tail between his legs ; except when weary and 
exhausted he seeks his home. 

The earliest symptoms of madness in the dog, are sulienness, 
fidgetiness, continual shifting of posture, a steadfast gaze, 
expressive of suspicion, an earnest licking of some part, on which 
a scar may generally he found. II the ear be the affected nart, 



Hydrophobia, or Bite of Mad Dog. 223 

the dog is incessantly and violently scratching it. If it be tht 

toot, he gnaws it till the integuments are destroyed. Occasion- 
ally vomiting and a depraved appetite are very early noticeable. 
The dog will pick up and swallow bits of thread or silk from the 
carpet, hair, straw, and frequently he will lap his own urine, 
and devour his own excrement. Then the animal becomes 
irascible, and flies fiercely at strangers, is impatient of correction, 
seizes the whip or stick, quarrels with his own companions, 
eagerly hunts and worries cats, demolishes his bed, and, if 
chained up, makes violent efforts to escape, tearing his kennel 
to pieces with his teeth. If he be at large, he usually attacks 
only those dogs that come in his way ; but if he be naturally 
ferocious, he will diligently and perse veringly seek his enemy. 

Many cautions are annually put forth about the dog days, 
for muzzling dogs, and so on. Very good and proper advice ; 
but if those who have noticed the statistics of the disease may 
be depended upon, it would be as appropriate at one period of 
the year as at another. Some people think this disorder in dogs 
is produced in warm weather on account of a want of water, the 
notion is a mistaken one. 

When an individual has been bitten by an animal respecting 
which the slightest su&picion of hydrophobia exists, the 
one remedy cannot be to quickly resorted to — complete 
excision of the bitten part. Some persons have possessed 
sufficient nerve to do this for themselves — few perhaps could — • 
but it has been effected by unprofessional persons for others : in- 
deed, there might be more danger in waiting many hours for a 
surgeon than in submitting to an unprofessional operation. The 
method of excision most to be trusted, is the insertion of a 
6kewer ol wood, made to fit into the wound caused by the 
tooth, and carrying the incision so far round, that the entire 
hollow or cone of flesh is cut out along with the piece of wood. 
This might be done with safety in the thick part of the calves 
of the legs or the back part of the thighs, &c. Where excision 
is not resorted to, the free application of lunar caustic or 
aquafortis, whichever may be most readily procured, would be 
advisable ; or, in lieu of these, a piece of iron, heated to white- 
ness, may be inserted into the wound, so as thoroughly to de- 
stroy the surface which may have been poisoned. In the evrent 
of none of the above measures being submitted to, oi\ available, 
the wound may be thoroughly washed for hours, by mOans of a 
stream of warm water poured upon it from a height ; a cup- 
ping-glass being applied at intervals, and of course in the 
meantime procure the services of a physician. When an indi- 
ridual is thought to be attacked with the hydrophobia, if the 



224 Lock-Jaw, or Tetanus. 

hope of saving life is small, much may be done to alleviate so 
terrible an infliction by proper care. The most perfect quiet- 
ness possible must be observed to prevent as much as may be 
the recurrence of the paroxysms of suffering. Thirty or forty 
drops of laudanum given as the occasion may require, are ad- 
visable — if the patient can swallow : if not we must depend 
on chloroform, which can be inhaled without difficulty, until 
rest is obtained — and repeated as may be needed. If ice can be 
taken, it is said to afford relief put into the mouth in small 
morsels ; it has also been found of service applied to the back o^ 
the neck. 

Anyhow the experiment ia worth trying. It has been stated 
that applying ice in bags or sacks to the backbone, has checked 
the disease ; when it can be had of course give it a trial. 

LOCK-JAW, OR TETANUS. 

This is an involuntary and almost constant contraction of the 
several muscles of the body, while the senses remain perfect. 
It is called Loch Jaw on account of the Jaws being locked 
together, as it were by the contraction of the muscles. The 
set of muscles most generally affected, after those of the jawn, 
are those of the back ; the patient, by the spasm, is bent like 
an arch, so that the back of the head and the heels alone touch 
the bed ; occasionally the body is bent forward. The disease 
most frequently commences with a sensation of stiffness and 
soreness of the muscles of the neck and jaws ; the latter be- 
come fixed, and the spasm extends more or less over the body. 
This extensive cramp is attended with the most severe pain, 
which is also, in most cases, experienced severely about the pit 
of the stomach, being dependent doubtless on the spasm of the 
diaphragm. 

The most usual exciting causes of lock-jaw or tetanus are 
wounds, especially of a punctured character, but in some per- 
sons the very slightest injury is sufficient to develope the disease. 
It is liable to prevail among the wounded after battles, if ex- 
posed to much bad weather; indeed cold will occasionally give 
rise to lock-jaw independent of injury. When lock-jaw arises 
from a wound, it shows itself in from four days to three weeka 
after the injury. It is a very fatal disease, the greater portion 
ot those affected by it dying; some, however, recover. 

In the treatment of lock-jaw, begin by giving large doses of 
Laudanum, say, from thirty to sixty drops if it can possibly be 
swallowed, and repeated at intervals of from half an hour to an 
hour, as long as the system remains unaffected by the drug : 



Sterility or Barrenness. 225 

if the medicine cannot be given by the mouth, it must be by 
injection. In addition to the above, the affusion with cold 
water may relieve. The patient having been taken out of bed ; 
and a quantity of cold water dashed over the body and down 
i\if spine, is immediately to be rubbed dry and replaced in bed 
5[uiet sleep may possibly follow. While the jaws are firmly 
closed, nourishment cannot of course be given in the usual way; 
* medical man will probably administer it by means of a tube 
passed into the stomach, either by ilie nose or by mouth, pass- 
ing it behind the teeth ; until his arrival, should that be de- 
layed, the administration of small injections of meat-broth will 
assist in keeping up the strength. 

Mustard plasters applied the entire length of the back-bone 
or spine, until pain and redness is produced, and after their re- 
moval, the application of cloths soaked in a mixture of equal 
parts of Sweet oil, Laudanum and Chloroform, and over them 
oil silk or writing paper, is a treatment I would by all means 
advise. Sometimes large doses of Ipecac or Antimonial wine, 
given until nausea is produced, will relax the muscles; the bow- 
els should first be moved, however, by injections. 

STERILITY, OR BARRENNESS. 

This, sometimes, proceeds from defective organization. These 
cases are, however, very rare, and cannot be cured by art. The 
next general cause is a torpor, and irregular action in the womb 
and its appendages, which by proper management ought to be 
cured. 

The most important means of rousing the womb, will be 
round in exciting the breasts to their natural action. The con- 
nection between the womb and the breasts, has often been re- 
marked : it is scarcely possible to excite an action in the one, 
without affecting the other. 

The most natural action for the breasts, is the secretion of 
milk. They have often been excited to the discharge, without 
pregrancy. A child losing its mother, and sleeping with a 
female friend, has been known in the night to get the nipple in 
the mouth, and to excite the flow of milk by the morning, and 
the child was abundantly nourished afterwards at the breast of 
the maid. The idea wished to be conveyed is, that to stimulate 
the womb of a woman who has been barren or unfruitful, it is only 
necessary to cause a flow of milk for a short time in her breasts 
by applying a child, (as in the case just cited) and that the 
stimulus thus brought to bear on the womb and its appenda- 
ges, will cause the woman to conceive and bear children. I 
give this not as my own opinion, but as the opinion of justly 



223 Chills, or Fever and Ague. 

celebrated medical men. To those who have been barren and 
who desire the companionship and blessings of children on 
whom they may lavish their love, and perchance their property, 
the experiment is worth trying. 

CHILLS, OR FEVER AJTI> AGUE. 

This disease prevails mostly in the fall of the year, and new 
lowlands, marshes, and on the water courses of rivers. The dis- 
ease occurs at stated and very various intervals — either daily, 
or every second, third or fourth day. 

Ague and fever, is generally divided by writers into three 
gtages : — the cold, the hot, and the sweating, and is thus de- 
scribed. — The cold stage commences with a sense of languor, of 
weakness, and aversion to motion and to food, with frequent 
yawning and stretching. The face and extremities become 
pale ; the features shrink, as do all parts of the body ; the 
skin appears constricted, as if it had been exposed to cold. At 
length, the patient feels very cold, and universal shaking comes 
on : breathing is small, frequent and anxious ; the urine is 
almost colorlesss : sensibility is impaired ; the pulse is small, 
frequent and sometimes irregular. 

These symptoms abating after a short time, the second stage 
commences with an increase of heat over the whole body, redness 
of the face, dryness of the skin, thirst, pain in the head, throb- 
bing in the temple, anxiety, and restlessness : the breathing be- 
comes more full and free, but still frequent ; the tongue is 
furred, and the pulse becomes regular, hard and full ; in cases 
of great severity, delirium is apt to occur. 

These symptoms having continued for some time, a moisture 
breaks out on the forehead, and by degrees becomes a sweat, 
which gradually extends over the whole body. As this contin- 
ues to flow, the heat of the body abates, the thirst ceases, the 
urine deposits a sediment ; breathing is free and full, and most 
of the functions are restored to their ordinary state ; the 
patient, however, being left in a state of weakness proportion- 
ate to the violence of the preceding attack. 

Although this is the description of a common fit of ague 
and fever, it is subject to great variations in every stage ; de- 
pending on as great variety in causes and peculiarity of consti- 
tutions. The treatment, whether the disease recurs every day 
or otherwise, is the same. Our object is to shorten the duration 
ot the fit when it comes on, and to prevent its recurrence. 

The treatment when the fit comes on, is, in the cold stage, 
to take any weak tea as hot as possible ; to apply hot appli- 
cations to the feet ; and to lessen the shaking, it is of servic* 



Chills, or Fever and Ague. 227 

to grapp the limbs very tight, or to apply tight bandages around 
them to compress the muscles. When this stage subsides, the 
drinks should be continued, and twenty drops of spirits of nitre 
in two tablespoonfuls of water should be given hourly, to favor 
the sweating. If the symptoms run alarmingly high, as ia 
sometimes the case in congestive chills, black pepper tea with 
a little wine, brandy or whisky in it, should be given occasion* 
ally, while at the same time we try to produce vomiting by tick- 
ling the throat with the finger or a feather, and use friction 
with hot cloths, &c. During the sweating stage, the patient should 
not be kept very warm, but not exposed to such a current of air 
as might endanger the sudden suppression of the perspiration; 
when it ceases the patient should be wiped dry with a rough 
towel, have the clothes changed and partake of some suitable 
nourishment. 

Of course the great object T 'n this disease must be to break 
the chill* or prevent its recurrence. For this purpose nothing is 
equal to Quinine. Commence six hours before the expected 
attacks of the chill, and take from one to three grains of the 
quinine every two hours, until the time for having the chill is 
past. Do the same way the next period, or day when a chill is 
expected. When the chill has been broken up, then every 
sixth or seventh day afterwards, take the quinine, until the 
fourth week or twenty eighth day has passed. The quinine 
may be taken in powder, mixed in a tablespoonful or two of 
cold water, or in the form of a pill. 

The patient should not eat much the day that the chill is ex- 
pected, and must also avoid exposure to the night air, and wear 
flannel next the skin. Bathing with a sponge and water, (to 
which a little^ salt has been added) night and morning, is advisa- 
ble. As a strengthening bitter tonic take a wineglassful of tea, 
[col 4 { made from wild cherry, or dogwood bark, or columbo root, 
before each meal. 

In the most obdurate cases, I have found the above treat* 
inent successful, in my practice in Mississippi and Tennessee, 
as well as since living in the city of New York. One thing 
should be observed, however, that before giving the quinine, in 
the very beginning, it is best to purge the bowels freely. Give 
five to ten grains of blue mass (blue pill) with half a grain of 
ipecac, at bedtime, to be followed the following morning by a dose 
of castor oil or a seidlitz powder, and repeat them, if necessary 
to work off the blue pill. You are then ready to begin with the 
qninine treatment as above mentioned 



228 Bilious, or Remittent Fever. 

BILIOUS OR REMITTENT FEVER. 

This is nothing more than the Chills, or Ague and Fever, ex 
cept in this form of the disease there are no intermissions, (of 
entire absence of the symptoms,) though there are remission* 
or partial suspension of the fever, followed by something like 
a chill or coldness of the nose, &c. 

The treatment consists in giving Quinine in the same dosee 
as ordered for Ague and Fever, only it should be given every 
three hours, both day and night, until the fever is broken up, 
and between each dose of the Quinine give twenty drops 0/ 
Spirits of Nitre in half a glass of water. 

Cold applications to the head (cloths wrung out of cold watei 
or water and vinegar, are about as good as any,) will be benefi- 
cial. Allow cool drinks of lemonade and slippery elm- water, or 
gum arabic water, &c. Give the blue pill, &c, as before refer- 
red to, before beginning the use of the Quinine, and during 
convalescence use the bitter tonics, &c, the same as recommended 
in the treatment of Ague and Fever; tea-spoonful doses of pre- 
pared chalk and powdered charcoal, given once a day in a little 
slippery elm- water, will be good to correct acidity of the ston> 
ach, and offensive discharges from the bowels. 

FAINTING FITS. 

These are liable to occur at any time in persons who are sub- 
ject to them, and always create for the time being, considerable 
excitement, especially when occurring in a crowded assembly or in 
the public streets, &c. These sometimes come on suddenly, 
without any visible warning; and, at others, they are preceded 
by sickness at the stomach — some oppression in breathing- 
paleness of face, &c. They are characterised by an entire suspen- 
sion of all the animal powers; which continuing for a short time, 
they become gradually restored. In rousing the system to ac- 
tion, we are first freely to admit fresh air, exclude all unnecessa- 
ry attendants, and see that no tight clothing is interfering with 
the breathing, &c— especially removing tight-laced jackets, 
corsets or cravats. Cold water or vinegar should be sprinkled 
on the face : strong smelling articles should be applied to the 
nose — as volatile salts (hartshorn) ether, assafcetida, burnt, 
feathers, &c. A little wine, or spirit, should be poured into the 
mouth, and the extremities rubbed with a coarse brush. The di- 
rect cause of fainting is diminished circulation of blood through 
the brain. It must be obvious, that in the endeavors to restore 



St. Vitus' Dance. 229 

a person who has fainted, this condition must be altered as 
auickly as possible ; and for this purpose, the individual should 
be laid quite flat down, the head on a level with body, so that 
the feebly-acting heart may not have to propel the blood up- 
ward, but horizontally. 

After fainting from excessive evacuations, cordials and stimu- 
lating diets should be often given. The patient should be laid 
down and kept at perfect rest, with hot applications to the breast 
and extremities. 

Remember, though, that when the fainting arises from a great 
loss of blood, it ought not to be stopped suddenly ; [the faint- 
ing fit] ; because during such fainting the blood coagulates and 
the vessels contract — thereby tending to prevent the continu- 
ance of the bleeding. 

Persons liable to fainting, or indeed to any kind of fits, can- 
not be too cautious in avoiding what they have found tending 
to produce them ; they should never be alone ; because of the 
danger of falling so that respiration cannot be renewed, and con- 
sequently ending in death, when others are not at hand to 
change the position of the body. 

In general, persons subject to fits who are of a weakly, deli- 
cate nature, will find relief by leading a more energetic life, oc- 
casionally using some of the strengthening medicines mentioned 
under the head of Tonics in other parts of this work. 

ST. VITUS 9 DANCE. 

This is mostly a disease of youth, occurring before puberty, 
ftnd usually disappearing at that period of life, if it has contin- 
ued so long. It may, however, continue into adult life, but rare- 
ly proves fatal. The most prominent symptom of St. Vitus' 
dance is continued involuntary actions of the muscles, to a 
greater or less degree — the extent of the muscles affected, and 
the intensity of their affection, varying with the severity of the 
disease. The movements, however, generally cease entirely 
during sleep, and in all cases certainly are diminished. The ordin- 
ary voluntary movements are still capable of being performed 
after a fashion ; that is, in an unsteady, uncertain, and somewhat 
grotesque manner. It seems as if, after the voluntary impulse 
had been communicated to them, an additional involuntary one 
interfered to throw the limb or other part, out of the usual steady 
movement. 

Usually the disease commences with twitching about the face 
or neck, or in a particular limb, gradually extending to one side 
of the body, or to the whole body, as the case may be. Pain ii 
•eldom complained of, but it does sometimes occur in the head 



230 Epileptic Fits. 

The appetite may remain quite good, but the bowels are possibly 
confined, and their secretions unhealthy. To this depraved 
state of the bowels, or to costiveness, or to the presence of 
worms, the disease is often traceable. In females it is not un- 
frequently connected with the menstrual function, (monthly 
turns) especially if it be delayed, or imperfect. The ir- 
ritation of the coming of the second teeth, has been assigned as 
a cause ; and there is no doubt that imitation, especially among 
females, may spread the disease, which is most general, as 
might be expected, in persons of a nervous tendency. The da- 
ration of the attack varies from ten days or a fortnight, to 
months ; but having once existed, it is, up to the age of twelve 
or fourteen at least, apt to recur occasionally. 

A great many cases of this disease get well without any treat • 
ment, but it is not best to trust to nature alone. The bowels 
should be purged with one blue pill (three grains) at bedtime, 
and followed next morning by a teaspoonfull of Kochelle salts 
or Epsom salts in half a gill of water, so as to work off the blue 
pill. Some mild purgative should also be given once a week 
afterwards, to keep the bowels open; castor oil will answer. In 
all cases attention to the general health is required. Good diet, 
exercise, change ot air, and attention to the hours of sleep, put- 
ting the child to bed at a stated hour every night, and to free 
ventilation of sleeping rooms, are all circumstances to be kept 
in mind in such cases. Bathing by means of a sponge, with 
salt and water every morning, is of great service. Also give 
one half to one teaspoonful three times a day of the following 
mixture; — tincture of Peruvian bark, tincture of valerian, 
spirits of lavender, tincture of henbane, orhyoscyamus, of each 
one once ; spirits of camphor, half an ounce, all mixed together 
and kept in a closely-corked bottle. 

EPILEPTIC FITS. 

This disease consists in a sudden deprivation of the senses : 
accompanied with a. violent convulsive motion of the whole 
body. It attacks by fits, and after a certain time goes off; leav- 
ing the person in his usual state, excepting a sensation of lan- 
guor and exhaustion. 

The fits, or convulsive seizures of epilepsy, are most va- 
ried as to the time of their occurrence. Frequently the 
interval is one of months, but again, daily fits, or even 
two or three times a day, are the rule, in the worst ca- 
ses. The attack of epilepsy is for the most part sudden: thi. 
individual, in the midst of some accustomed occupation, 01 
while holding active communion with persons around, sud- 



Epileptic Fits. 231 

denly utters a loud — a fearful — cry, and, if unsupported, 
falls to the ground ; the eyes are staring or rolling ; the head, 
or rather chin, is drawn toward one shoulder, the countenance 
becomes dark or purple, the veins of the face and temples filled 
with blood, and the features are thrown into convulsive move- 
ment ; there is frothing at the mouth, while a kind of choking 
noise is often made in the throat ; the limbs are also more or lesa 
convulsed, and the excretions are often expelled involuntarily. 
The tongue very often suffers from being bitten, and the teeth 
have even been fractured during the tit. Gradually, these con- 
vulsive movements diminish, and the person awakes to con- 
sciousness, with a heavy stupid look, or falls into a deep leth- 
argic sleep, which continues for some hours ; but even when 
roused from this, there often remains slight temporary suspen- 
sion of the activity of the brain. Such are the symptoms of a 
severe epileptic paroxysm; the disease, however, occurs in much 
milder forms, even in those who at other times suffer from it 
in greater intensity. A slight temporary unconsciousness 
may be the only symptom, with or without the slightest ap- 
proach to convulsive movement, as evidenced by the twitching 
of a finger, the roll of an eye, or slight spasmodic action of the 
muscles of the face ; the patient may fall gently as in a faint, or 
remain standing as it were asleep for a few moments. As there is 
every variety in the nature of the attacks, so is there likewise 
in their duration ; from a few moments to the average period of 
from five to eight minutes, but sometimes much longer. 

The attack in many cases appears to bystanders to come on 
suddenly and without warning ; but most epileptic patients are 
sensible for some time previously of the approach of the parox- 
ysm, and even for twenty-four hours are aware that a fit is at 
least probable, although its direct accession may not be certain- 
ly known until just previous to its occurrence. It may, however, 
happen that these symptoms will pass off without a fit, either 
independently of any effort of the patient to ward off the at- 
tack, or in consequence of some of those measures found to be 
efficacious, and adopted by epileptic patients for the purpose. 

Low spirits, or unusual irritability, sometimes an increased 
energy, dizziness, noises in the ears, floating specks before the 
eyes, and many other signs connected with disorder of the ner- 
vous system, are the precursors of the epileptie paroxysm. But 
the most generally marked and remarked precedent is the epil- 
eptic " aura," a sort of creeping sensation, which is described by 
the patient as arising at some particular part of the body, sucn 
as the extremity of a limb, and gradually ascending upward to 



232 Epileptic Fits. 

the trunk or head, till the individual loses his consciousness 
in the convulsion. 

Epileptic seizures are very frequent in the night-time, just as 
the person is falling asleep ; but they may occur at any period 
of the twenty-four hours, and may be induced by causes affecting 
the nervous system ; the excitement of joy or passion, or depres- 
sion of grief, intoxication and sexual excesses, are most fre- 
quently not only actual exciters, but also predisposers, to the 
attack of epilepsy. 

Epilepsy may be a congenital disease, that is, the child is 
born with the tendency and becomes subject to the fits, either 
with or without any apparent cause, early in life. Intoxica- 
tion is a cause of epilepsy, and delirium tremens may be com- 
plicated with it. Strong and prolonged mental exertion may 
induce epilepsy. Fright is another and very frequent exciting 
cause. Worms and irritations in the bowels, indeed whatever 
can irritate the nervous system, may induce the disease in ques- 
tion. Imitation, or at least witnessing an individual in the ep- 
ileptic paroxysms, has been known to give rise to the fits in 
others ; but they were most likely predisposed, or at all events 
of nervous and susceptible temperament ; for this reason, such 
persons, young females and children especially, should never, if 
possible, be permitted to witness an epileptic fit. The pre- 
monitory cry is so terrifying that it has been known to affect 
even the lower animals. 

When means will allow of it, the epileptic ought to have an 
attendant constantly with them. When an individual is seized 
with a fit of epilepsy, but little can be done for its immediate 
relief : the chief thing was to prevent the inflicting injury up- 
on himself, by striking against surrounding objects, and 
also to protect the tongue. Those who are much in attend- 
ance upon the epileptic ought always to have on hand a piece 
of India-rubber, or a thick India-rubber ring — such as is used 
for children teething — to insert between the teeth. All fasten- 
ing about the body, such as the neckcloth, &c, ought to be 
loosened, and air freely admitted ; the head should be raised, 
and cold wet cloths may be applied to it if there is much heat, 
jthas been advised to cram the mouth full of salt as soon as the 
fit comes on. Dr. Watson, who had the plan tried in hospital, 
thought it seemed to curtail the duration of the convulsion. 

The most important treatment is during the intervals ; mix 
together half a teacupful of ground mustard, two table spoon- 
fuls of laudanum, three table spoonfuls of tincture of cayenne 
pepper, half pint of vinegar, and same amount of cold water and 
alcohol, put into a well-stopped bottle, shake well, and apply this 



Drowning, 238 

as a Unimmt along the backbone (or spine) with a woollen 
cloth, night and morning, wearing a flannel shirt next the skin 
all the time. Also, take inwardly the following : tincture of 
extract of skullcap, tincture of valerian, tincture of hyoseiamus, 
(henbane) spirits lavender, of each one ounce, dose, one tea- 
spoonful three times a day. 

Keep the bowels open, take plenty of exercise in the air 
and avoid all kinds of excitement. A sponge bath every 
morning, is a good remedy, also pouring water [or a shower- 
bath] on the head at the same time, is recommended by 
physicians. 

DBOJnflNG. 

This is of such frequent occurrence that every man, woman, 
and child, should know what to do in cases of apparent death 
from drowning — in fact it should be a part of the education of 
our children, from the fact that it often happens that children 
are the only persons present when one of their little playmates 
tails into the water, and while going for help the sufferer dies 
for want of the proper attention. 

The first thing to be done when a person apparently 
drowned is rescued from the water, is to wipe and cleanse 
thoroughly the mouth and nostrils — the next to apply warmth 
to the body. This last cannot possibly he done as long as* it is 
covered with wet clothing ; and if this is the case, it should be 
removed, cut off, if necessary for haste — as quickly as possible. 
If there is a house or shelter of any kind very near the spot 
where the body is got out, it may be taken to it at once, and 
before the clothes are removed ; but if such is not the case,^>n?- 
vided dry coverings are at hand, the wet clothes should he strip- 
ped off on the spot. Wrapping the body in blankets is always 
to be preferred. In removing the body it is best done by laying 
it on the back or side, on some flat board, such as a door or shut- 
ter, the head and shoulders being well raised ; but if there is no- 
thing at hand on which the body can be laid, care should be 
taken in carrying it that the head is well supported neither allow- 
ed to fall back, nor forward upon the chest. As soon as may be, 
warmth is to be applied to the entire external surface ; if a 
warm bath is available, it should be used, if not, the body is to 
be covered up with warm things ; bags of hot bran, hot salt, or 
sand, or any other convenient vehicles for heat, are to be placed 
wherever they can be without interfering with the necessary 
manipulations : to the pit of the stomach and to the feet espe- 
cially, their application is to be used. Frictions with stimulants 
of some kind, such as camphorated oil, brandy or any other spirit 



234 Drowning. 

mixed with oil, of-turpentine, should any of them bo used 
warm, and be rubbed in with a flannel ; a warm stimulant in- 
jeotion, consisting of gruel, containing a tab! espoonful of tur- 
pentine, or double the quantity of brandy, may be given, and 
stroug-smelling salts held to the nostrils at intervals. Artifi 
cial breathing, recommended by some, is condemned by others. 
Certainly the old method of using bellows and other means to 
inflate the lungs was much more likely to do harm than good, 
particularly in the hands of the unprofessional, who would be 
much more likely to inflate the stomach, and thus impede the 
breathing. Attempts to imitate the natural process of respira- 
tion may, however, be made, by pressing inward the ribs and 
pit of the stomach, and allowing them to rise again by their own 
elasticity, repeating this process twenty times in the minute. 

External warmth and continued friction, with care taken that 
the shoulders and head are raised, the mouth and nostrils freed 
and carfnlly keeping the patient wrapped up in blankets, are 
of the greatest importance. For the more easy application of re- 
medies, the body should be laid on a table of convenient height 

It is necessary to notice also what ought not to he done; for 
many old and most injurious modes of treatment are still apt to 
be resorted to by the ignorant and prejudiced. Most of these 
have originated in the idea that water swallowed was, or had 
something to do with the cause of death ; hence patients have 
been hung up by the heels, rolled on barrels, choked with 
emetics, under the idea of making them disgorge the water, 

If there is much water swallowed — as sometimes happens — 
it would be better to remove it ; but any means which unpro- 
fessional persons can use for its removal would only be a worse 
evil. If a medical man is present, and thinks well to use the 
6tomach-pump quickly, remove the water and replace it with a 
small quantity of hot brandy and water, it may be of service, 
but no attempts should be made to give any thing by the mouth 
as long as unconsciousness continues. 

J Never despair of these cases, for when all hope seems to have 
vanished and no sign of life been given for one, two, or four 
six, or even eight hours, the perseverance of those around has 
been at last rewarded, and life preserved. 

After a person has been restored to consciousness, there may 
be considerable congestion of blood about the head, which may 
require leeches or scarifying the temples. In all cases of recov- 
ery, the greatest care must be taken to preserve the re-excited 
actions ; if stimulants are thought requisite they must be given 
cautiously ; guard against any excitement foom friends or rela- 
tives ; and support the strength by tea, coffee, Boups, &c, 



Hanging. 235 

and let the patient be warmly wrapped in blankets in bed 
until the perspiration is started, after which they may be consid- 
ered safe. 

HANGING. 

This may cause death in three ways : by simply compressing 
the wind-pipe, by which death is caused by suffocation ; by 
apoplexy, from compression of the veins of the neck, or by dislo- 
cating the neck, which is not often the case. 

Recovery from hanging" must, in some degree, depend upon 
the completeness or not, of the interruption to the passage of air 
through the wind-pipe for any time ; it is not likely that resus- 
citation will be effected if this thing has contmxiedi four min- 
utes. The first thing to be done when a person is found hang- 
ing is, of course, to cut them down at once, to loosen the material 
around the neck, to dash cold water over them, and to bleed 
from a vein in the arm or foot, or temple. In such an emer- 
gency, a person would be justfied in cutting across the temple 
where the artery runs, (or beats), with a sharp knife of any 
kind, allowing the blood to flow freely. The bleeding could be 
checked when desired by pressing with the thumb over the 
part or putting burnt alum into the wound. With the except- 
ion of applying heat, and removing the clothing, the treatment 
of hanging is very much the same as in cases of apparent death 
from drowning. I should advise, however, that as soon as life 
is thoroughly restored, and after the patient has had time to 
think over his folly a little, in cases of attempted suicide, by 
whatever means may have been selected, that the person so 
offending should be thoroughly flogged, and then made to do 
the state some service for a month or two. The prevalence of 
this sin, and the consequent notoriety that is given to deaths 
from this cause in the newspaper press of the day, should be 
looked upon by every body with disfavor. No man or woman 
who thus tries to rush unbidden into the presence of God, de- 
serves a falling tear, or a newspaper notice, unless iusanity has 
been the cause. 

CHOKE-DAMP, 

Or Apparent Death from Inhaling Carbonic Acid Gas. 

How many sad instances of deaths from this cause every year 
\nd yet a little knowlege, such as we have tried plainly to im- 
part in this book, would have prevented an occurrence of this 
kind. Old wells, brewersWats, the holds of ships, &c, are all 
liable to become the receptacles for cabonic acid gas, which, 
formed from some decomposing vegetable matter, lies like a 



236 Choke-Damp 

stratum of water at the bottom. Should any one incautiously 
descend, so as to become enveloped in the carbonic acid atmos- 
phere breathing is either instantly stopped by spasmodic closure 
of the chink at the upper portion of the windpipe, and com- 
plete suffocation is the consequence ; or the gas, if sufficiently 
dilated with air to be drawn into the lungs, speedily manifests 
its narcotic effects upon the system, and the person quickly falls 
in a complete state of stupor. The breathing becomes difficult, 
and after a time ceases ; the countenance is purple or pale, and 
there may be convulsion and frothing at the mouth. In such a 
case, the body of the individual must be removed, if possible, 
and as soon as possible, from the poisonous atmosphere, or the 
latter must be destroyed or dispersed. 

The many fatal accidents which have occurred from persons 
venturing rashly into wells, and such like places, mignt be a 
warning for the future, and prompt the invariable employ- 
ment of the simple test of lowering a lighted candle into 
the suspected place. If the flame be extinguished, the atmos- 
phere is destructive to life ; if it burn even with a feeble and 
diminished intensity, there is danger. Of the various modes for 
destroying a carbonic acid atmosphere, none is more speedily 
effective than the intoduction into it of newly slaked lime 
either spread upon a board, or mixed with water, and dashed 
into the place ; fresh lime, having a powerful affinity for car- 
bonic acid, quickly absorbs it. In the absence of lime, a 
quantity of fresh water dashed freely down, so as at the same 
time to absorb the gas and promote the circulation of air, will 
be serviceable* or large bundles of combustible material, which 
will cause currents of air, may, when blazing freely, be thrown 
in. Caution in the first instance is the best preservative ;but 
in the event of an individual dropping in an atmosphere of 
choke-damp, it is perfectly useless for others to rush in to bring 
him out ; they can no more exist in it than he could, and in 
stooping to lift a fallen body, they become all the more 
thoroughly immersed in the poisonous gas. Instead of rashly 
sacrificing life in the ill-directed endeavor to rescue another, let 
those who are present dash bucket after bucket of water or 
weak lime and water into the place, and on the fallen person, 
until the unextinguished flame tokens that the fatal atmosphere 
is weakened at least ; and when they do venture in, tie over 
the mouth a cloak soaked in lime-water, or of simple water, if 
the other cannot be obtained. 

When from any cause, a person gets into choke-damp as 
above described, cold water should be dashed freely over the in- 
dividual as soon as removed into the open air, and this measure 



Stroke of Lightning, 237 

succeeded by heat applied to the surface, stimulant embroca- 
tions to the chest, spine, &c, stimulant injections, and ammonia 
held at intervals to the nostrils, while artificial breathing (as 
described under the head of Drowning) is at the same time 
brought into action, and steadily persevered in for some hours. 

Carbonic acid is produced during fermentation, or by slow de- 
composition of vegetable matter, such as damp straw, sawdust, 
wood-chips, &c. It is the gas disengaged in effervescing liquors 
generally; it is also produced, along with other vapors of 
which carbon forms a constituent, in the burning of charcoal. 

Poisoning by charcoal fumes, either by design or accident, is 
not an unfrequent occurrence. In the latter case it usually oc- 
curs from persons ignorantly retiring to sleep in a closed-up room, 
in which burning charcoal is used as a means of warmth. The 
carbonic acid and other fumes disengaged, act slowly and insidi- 
ously, and exerts so powerful a narcotizing or stupiiying effect, 
that those exposed to the influence are quickly rendered unable 
to remedy the circumstances, and perfect insensibility ensues. 
Too often it happens that the discovery of the accident does not 
take place until morning, long after it is too late to remedy the fa- 
tal effects ; the sufferers being usually found dead. If living, they 
will probably be perfectly insensible ; the countenance pale and 
livid. Immediate removal to the open air, and free exposure to 
its influence by removal of the greater part of the clothing, is 
the first proceeding, when the treatment recommended in cases 
of poisoning from choke damp should be followed. Carbonic 
acid is largely given off in the process of lime burning, and per- 
sons who have incautiously slept in the immediate neighborhood 
of a lime-kiln, have been d-estroyed by it. 

STROKE OF L1GHTNIXG. 

Every summer tells the story of death from lightning. There 
can be no doubt that in many instances life could be preserved 
by the application of the proper treatment in time. Persons 
who are stunned, but not killed, by lightning, generally remain 
in a state of insensibility for some time, the breathing being 
slow and deep, the muscular system relaxed. In such cases it 
will be proper to use means for preserving the animal warmth, 
which has a tendency to become depressed, to keep up artificial 
breathing as recommended under head of Browning, to use mus- 
tard-plasters to the spine and pit of the stomach, to administer, 
from time to time, a little hartshorn in water, if the patient can 
swallow-if not, togiveawarm injection, containing half an ounce 
of turpentine-—or to use such other means as are recommended 
under Drowning and Choke-damp, which may seem adapted 



238 Cramps. 

to the case. It is a common idea, that persons who have been 
killed by lightning do not stiffen, and that the blood remains 
fluid, but this is erroneous. It would, considering how often the 
fact is reiterated, seem almost superfluous to point out the or- 
dinary precautions which those who chance to be exposed to a 
storm of thunder and lightning ought to adopt; but not a sum- 
mer passes without lives being lost from sheer ignorance. Har- 
vest laborers and others will persist in sheltering under trees ; 
people will continue to put up even iron umbrellas in the midst 
of a thunder-storm, and mowers walk unconcernedly home with 
their scythes over their shoulders. If an individual is overtaken 
by a thunder-storm in a place where trees abound, he should 
avoid them as much as possible. A thorough soaking will be 
rather a protection than otherwise. If, on the contrary, the po- 
sition is on a wide plain, where the body is the highest object, 
lying down is the safest thing that can be done. In any 
case, metallic objects, such as sickles, scythes, &c, being laid 
aside at considerable distance- Under shelter, the most hazard- 
ous position appears to be in a draught or current of air, such 
as between a door and window, or, as is often the case, females 
sewing near a window or door. The fine pointed needle having, 
of course, a powerful attraction for the electric fluid. Every 
house should be protected by a lightning rod, it costs but a 
trifle and may save many valuable lives. 

CRAMPS* 

This is a painful contraction of various muscles, mostly of 
the muscles of the legs and arms. They may be confined to 
one or two mucles, such as those of the legs, or may be more 
general, as happens in cholera. The affected fibres are draw in 
hard, knotty contractions, and maintain this condition for a 
longer or shorter time. The most frequent causes are the pres- 
ence of indigestible food in the stomach, or of acid in the bowels, 
or the pressure exerted on the nerves by overloaded bowels. 
The weight and pressure of the child, acts in a similar manner 
in pregnancy and labor, and occasions painful and troublesome 
cramp. The disorder is also often associated with the presence 
of worms. When cramp affects the arms and fingers, it may 
be connected with diseases of the heart and great blood-vessels 
of the chest. The power of the application of sudden and 
prolonged cold in producing cramp, is often sadly exemplified in 
the case of bathers. The best immediate remedy for cramp is 
friction with the hand, or, better still, with a mixture of half 
a pint of vinegar, two tablespoonfuls of ground mustard, and 
one of cayenne pepper, to be rubbed on with a woolen cloth. 



External Violence. 239 

Shake well before using — one tablespoonful of laudanum added 
to the above, will be beneficial if it is to be had. "When the 
legs are affected, it is always expedient to take medicine,say ten 
grains of rhubarb and ten of magnesia, with fifteen grains of 
carbonate of soda and a little ginger ; and afterwards, to clear 
out the bowels with some active aperient, such as castor-oil, 
especially if there is any existence of costiveness, or a possibility 
of their being loaded. Some persons find relief from the imme- 
diate attack of cramp, by tying a band of some kind tightly 
round the limbs, between the affected part and the body, while 
others are in the habit of standing upon some cold substance. 
The first process is perfectly safe, and may be tried; the second 
certainly is often effectual, but it is not devoid of danger. Ac- 
tive friction with the dry hand, warmed, is the best temporary 
remedy. Cramp affecting the arms is always to be regarded with 
suspicion, if it occurs often. There is reason to fear some disease 
of the heart, lungs, or liver, the best plan would be to get a 
physician's advice, at once. 

EXTERNAL VIOLENCE. 

This is likely to occur from accident or design, at any time, 
and we should always be ready to meet these emergencies* It 
is my desire that every purchaser of this book will carefully 
read it, especially those parts of it which treats of things 
requiring immediate attention. A stroke or injury on the head 
may cause merely bruising of the scalp; if more severe, con- 
cussion or injury to the brain, or fracture of the skull. The 
latter accident is most likely to happen at the side of the tern* 
pie, where the bone is thin ; but severe injury to the brain fre- 
quently occurs from blows at the under and back parts of the 
head. A severe blow on the back may cause paralysis (loss of 
feeling or motion, or both) of the lower limbs, with or without 
fracturing the bones. When a blow, even comparatively slight, 
is inflicted upon a spot immediatey over a collection of nerves, 
most distressing effects, and sometimes immediate death, may 
result. Such is the case from blows on the neck, on the pit of the 
stomach, or over the region of the heart. The deadly faintnes3 
which ensues, should instantly be combated by stimulants — 
ammonia, ether, or spirit of any kind — which can be procured. 
Cold water should be suddenly dashed over the surface or down 
the back. If this is unsuccessful, the patient is to be put into a 
warm bed, and artificial breathing, as mentioned under the head 
of Drowning, employed along with external heat, mustard- 
plasters to the back and pit of the stomach, and stimulating 



240 Cramp in the Stomach from drinking Cold A ater. 

injections of two or three tablespoonsful of whiskey, or brandy 
or spirits turpentine, with a like amount of sweet oil and a 



2*111 of warm water. 



to 



CRAMP IN THE STOMACH FROM DRINKING COLD 

WATER. 

There are a great many diseases, properly speaking, brought 
on by drinking ice-water, and eating water-ices and ice-cream, 
when the body is over heated, such as diarrhose, dysentery, in- 
flammation of the stomach, &c, but these will be treated of in 
their appropriate places. Our purpose here is to treat of 
"cramps" in the stomach only. There are three circumstances 
which concur to produce disease or death from drinking cold 
water : the patient is extremely warm, the water is extremely 
cold; and a large quantity of it is suddenly taken into the 
body. The danger from drinking is in proportion to the 
degrees which occur in the three circumstances mentioned. 

Soon after the patient has swallowed the water, he is affected 
by dimness of sight; he staggers in attempting to walk, and, 
unless supported, falls to the ground; he breathes with diffi- 
culty ; a rattling is heard in his throat ; his nostrils and cheeks 
expand and contract in every act of breathing ; his face appears 
suifused with blood, and of purple color ; his extremities be- 
come cold, and his pulse imperceptible ; and unless relief be 
speedily obtained, the disease terminates in death in a few min- 
utes. This description, of course, refers to the worst cases. 
More frequently the patient is seized with acute spasms in the 
breast and stomach. These spasms are sometimes so painful 
as to produce fainting. In the intervals of the spasms, the 
patient appears to be perfectly well. The intervals between 
each spasm become longer or shorter, according as the disease 
tends to life or death. 

Punch, beer, toddy and various other fancy drinks fixed up in 
drinking saloons, when drank under the same circumstances as 
cold water, have all been known to produce the same dangerous 
and fatal effects. The means to be tried for giving relief is strong 
stimulation, by large doses of laudanum, ether, spirits, &c.; and 
above all, it is necessary that the patient Should not be permitted 
te remain for an instant in a recumbent posture ; hut should he 
Icejpt in constant motion until relieved. A mixture of whiskey, 
brandy or gin, two to four tablespoonsful, cayenne pepper, half 
teaspoonful, and of laudanum thirty drops, to be taken in a 
little water as hot as it can be drank, will usually give speedy 
relief. The dose may need repeating in half an hour. For 
children reduce this dose according to age. At the same time 



Bite of Venemous Snakes* 241 

hot applications to the pit of the stomach, such as hot salt, 
6and, meal, ashes, &c, or a mixture of ground mustard and pep- 
per, with warm vinegar, applied in the same way. 

When heated, persons should abstain from drinking very cold 
water. Gargling the throat, or washing out the mouth in cold 
water, will allay thirst until the person has time to cool off. 

Where the powers of life appear to be suddenly suspended, 
the same remedies should be used which have been so success- 
fully employed in recovering persons supposed to be dead from 
drowning. Care should be taken in this, as in all cases of ap- 
parent death, to prevent the patient's suffering from being sur* 
rounded or attended by too many people. The act is kindly 
meant but it is very dangerous for the patient. 

BITE OF VENEMOUS SNAKES 

This may very properly be called a poisoned wound, for the 
poison is inserted at the same time the bite or wound is in- 
flicted. The wound in itself is generally trifling, perhaps not 
more than a scratch, but speedy death may follow. 

Immediately after being bitten by a poisonous snake, the 
parts begin to swell, and there is terrible and speedy depression 
of the vital powers of the system generally. When an individ- 
ual suffers from a wound known or believed to be poisonous, 
immediate steps should be taken to prevent if possible, the poi- 
son being absorbed into the system. The steps to be taken are 
sufficiently detailed in the article on hydrophobia. 

In addition to the local treatment of the wound (mentioned 
under head of Hydrophobia) continued friction with some oily 
material appears to be most generally useful, while at the same 
time, stimulants are freely given internally to counteract the 
depression. Of course, any stimulant first attainable should be 
used ; but hartshorn, is most highly recommended, taken in tea- 
spoonful doses every ten minutes, in a half a gill of water, until 
reaction has been established, and the patient is better ; being 
free from poison and the swelling checked. However, harts- 
horn may not be so handy to get at. Then take half a glass- 
ful of brandy, whiskey or spirits of any kind, every fifteen or 
twenty minutes, until the patient is fully under its influence, 
which will be when he is " dead drunk." It should not be for- 
gotten that the part bitten should in a moment be cut out r and 
then freely washed with water until hai tshorn or caustic can 
be applied, which can not always be obtained on the spot, but 
as soon as they can be either of them, apply to the bitten part. 



242 Neuralgia. 

NEURALGIA. 

This is a most prevalent disease of this fast age in which we 
live. Of its nature but little can be told, only that it is seated 
in the nerves, though having its origin, often, no doubt, in the 
excessive use of tea, coffee, rum and tobacco. However, 
some of the worst cases have been connected with diseased 
growth of tone in different parts of the head or face, especially 
about the canals through which the nerves pass : other severe 
cases have been found to depend upon irritation excited by 
foreign bodies acting upon some of the nerve branches ; de- 
cayed teeth are not infrequently connected with the disease. 
The most general seat of neuralgic pain is in the head or face ; 
but the fingers, the chest, the abdomen, &c, may any of them 
become affected. 

Persons afflicted with this disease have described it as a 
"plunging," darting pain of the most intense and agonizing 
kind ; but, except in long-continued cases, there is no external 
mark — no redness, swelling, or heat, to indicate the disorder 
to others, and many a sufferer from this disease has been taunt- 
ed with playing " Old Soldier," — a most cruel and unkind pro- 
cedure. After a severe attack of neuralgia, the skin is often 
left .tender, and when the pain has recurred frequently, exqui- 
sitely tender swelling of the part has been known to come on. 
The access of the pain is usually sudden, its remission equally 
so, and It is generally periodical in its attacks : it is suspended 
during sleep. 

Among the exciting causes of neuralgia are damp and cold, 
or damp alone, if combined with malaria, such as cause ague ; 
exposure to currents of cold air, more particularly if the indi- 
vidual is heated. Debility of constitution renders the indivi- 
dual much more susceptable to those and other exciting causes; 
it has often, too, been traced to anxiety of mind. 

It has been observed sometimes, that sudden attacks of neu- 
ralgic pain in various parts of the body, have been traced to 
temporary stomach disorders, such as superabundant acid, &c. 

If the patient is resident in a climate or situation likely to 
excite it, some change should, if possible, be made ; this will 
probably be most beneficial if the removal be to a dry, warm 
air; but should disease have commenced in a cold, dry dis- 
trict, change to a moist, but warm one, will probably offer 
most advantage. If disorder of the stomach exists, it must, of 
course, be rectified, by giving purgatives, such as any ordinary 
good purgative pill,or a dose of Rochelle 6alts,Rhubard, Seidlitz 
powder, or Castor oil, two or three times a week. After that, if 



fiea-sickness. 243 

the disease still continues, quinine, given in one or two grain 
doses, every six or eight hours, will most probably be of ser- 
vice. Carbonate of iron, in from half drachm to drachm doses, 
is a most useful remedy, especially in weak constitutions. Blis- 
ters behind the ears, or at the back of the neck, are often val- 
uable aids in the treatment of neuralgia of the face. To relieve 
the paroxism of pain, a sponge, or piece of flannel, dipped in 
boiling water, or vinegar and water, and applied as hot as it can 
be borne over the site of the pain, will often allay its severity, or 
remove it altogether. Opium internally may be given in very 
severe cases, or rubbed on the part. Chloroform applied to the 
affected part by means of a piece of lint soaked in it and covered 
with oil Silk, is a very successful application, and should be tried 
if it can be procured. A liniment made of Tincture of Arnica 
and Laudanum, in equal parts, applied often to the part affect- 
ed will afford speedy relief. Five grains of morphine, thorough- 
ly rubbed up into a tablespoonful of lard, to make an ointment, 
to which add ten drops of oil of lemon, while mixing, makes a 
good application to the painful parts, put on with the ball of 
the fingers every two or three hours. Friction to the affected 
parts with the dry hand, three times a day, during the intervals, 
should be strictly attended to, with a view to break up the 
disease. Electricity is often beneficial when all other means fail. 

SEA-SICKNESS. \ 

If any of my readers have ever known what it is to be " Sea- 
sick," they can, no doubt, say with the author, who dreads the 
Sea on that account more than any thing else, that a sail on the 
ocean wave is more sick than romantic. 

This sickness is considered to be dependent on some pecu- 
liar affection of the brain, produced by the rocking motion 
of the vessel. The affection is more readily caused by long 
heaving waves, than by a short rough sea. The best preven- 
tives of sea-sickness seem to be the horizontal posture, as near 
the centre of the vessel, and therefore of the centre of motion, 
as possible — that is, where the motion is least. Exposure to 
the open air rendersthe liability less. Stimulants, combined 
with sedatives, certainly appear to have considerable effect in 
preventing or alleviating the affection. A pill, composed of four 
grains of cayenne pepper, with two or three of extract of henbane, 
taken at intervals, may be found useful. Creasote is also an 
excellent antidote, — one or two drops made into a pill with 
bread crumb, to be repeated, if necessary, once or twice during 
the day. Some persons find themselves less liable to sea-sick- 



244 Seasickness. 

ness if they take food freely — with others the reverse is the cade J 
the effect probably depends upon the state of the digestive pow* 
ers of the stomach, temporary or permanent. If these are vigor* 
ous, the excitement of digesting food acts probably as a coun- 
ter-agent to the cause of the nausea. Sea-sickness, of itself, is 
rarely injurious, but it should be a subject of consideration with 
persons who are liable (or likely to be) to head-affection, who 
are the subjects of rupture, prolapsus, &c, how far they should 
incur the risk of these being aggravated by the mechanical ac- 
tion of vomiting. Some who do not suffer from sickness while 
on the water, experience nausea and other uncomfortable sensa- 
tions after landing — an effect, doubtless, due to a partial disturb- 
ance of the digestive organs, and probably to biliary disorder.— 
One or two doses, of Eochelle salts, or Oastor oil, will, general- 
ly remove the inconvenience. 

Some persons have been greatly, and often permanently re- 
lieved of sea-sickness, by taking from three to five drops of 
chloroform, put on a lump of sugar and swallowed immediate- 
ly, then going to bed, and, if possible, going to sleep. With 
children, rubbing the pit of the stomach with a 6ponge dipped 
in a few drops of ether, chloroform, or laudanum, or the three 
mixed together, will afford relief; or a cloth with some of this 
mixture dropped upon it and laid on the pit of the stomach, 
will answer. 

VdrIC0C6l0« — Almost the first symptom that is observed 
in the genital organs, produced either by masturbation or ex- 
cessive indulgence with females or other causes is a flabby, 
relaxed condition of the privates; the testicles hang lower 
than usual, the spermatic cord is relaxed, and there is a dull, 
aching, heavy, dragging feeling in the parts, with sometimes, 
in more advanced 6tages, pains shooting up occasionally into 
the groin and lower part of the abdomen, and also a heavy 
aching feeling in the small of the back. There is enlargement 
of one side, usually the left, and the scrotum feels like a bag 
of worms. There is pain, and at times a coldness and numb- 
ness in the privates. The disease is quite prevalent; the author 
has had no Jes3 than three hundred cases within the last few 
years, and has treated them successfully. 

The best treatment is to use a ventilated suspensory band- 
age to be worn all the time, and bathe the parts freely in cold 
water night and morning, also keep the bowels open. 



Hypochondria. 245 

HTrOCHOKDRIA. or Lowness of Spirits. 

Mild cases of this disease are called very often the 4 ' Blues* 
sometimes Hypo, etc. It is a condition of the mind, produced 
by real or imaginary causes, which should bo remedied as 
speedily as possible, before it gets too firm a hold on the system. 
The common symptoms are, loss of, or a variable appetite, & 
troublsome flatulency in the stomach or bowels, sour belchings, 
costiveness, a copious discharge of pale urine, sposmodic 
pains in various parts of the body, giddiness, dimness of sight, 
palpitation of the heart, general sleeplessness, and often an 
utter inability of fixing the attention upon any subject of im- 
portance, or engaging in any thing that demands vigor or 
courage. The mental feelings, and peculiar train of ideas 
that haunt the imagination and overwhelm the judgment, 
exhibit an infinite diversity : sometimes the hypochondriac is 
tormented with a visionary or exaggerated sense of pain, or 
of some concealed disease ; a whimsical dislike of particular 
persons, places, or things ; groundless apprehensions of per- 
sonal danger, or poverty ; a general listlessness and disgust, 
or an irksomeness and weariness of life. In other instances, 
the disease is strikingly accompanied with peevishness and 
general malevolence; the patients are soon tired with all 
things ; discontented, disquieted upon every light occasion, 
or no occasion ; often tempted to make way with themselves ; 
they cannot die, they will not live ; they complain, weep, 
lament, and think they lead a most miserable life : never was 
any one so bad. 

The whims that are sometimes seriously entertained under 
this complaint are of the most ludicrous description. 

Men have imagined that they were a lump of butter, and 
were afraid to go into the sunshine or near the fire for fear cc 
melting; others, that they were continually in someplace of dan- 
ger, and likely to be killed at any moment ; some have thought 
they had toads, snakes, and no telling how many imaginary 
things in their stomach that would sooner or later destroy 
them. As to the causes of this disease, there may be a strong 
constitutional predisposition, or the disease may be the conse- 
quence of a sedentary life of any kind, especially severe study 
protracted to a late hour in the night, and rarely relieved by 
social intercourse or exercise; debauched^ dissolute habits; 
great excesses in eating and drinking; the immoderate use 
of mercury, violent purgatives, the suppression of some habi- 
tual discharge or long continued eruption. Some peculiar affec- 
tion, such as congestion or fullness of one or more of the im- 
portant organs within the abdomen, is a frequent cause 



246 Hicewp. 

The principal objects of treatment in this disease are, to re- 
move the indigestion, to strengthen the body, and to enliven 
the spirits ; and one of the best plans with which we are ac- 
quainted, for the fulfillment of these intentions, is, constant 
exercise and change of jplace^ with a sponge bath about three 
times a week, early hours, regular meals, and pleasant conver- 
sation, the bowels being at the same time carefully regulated 
by the occasional use of gentle purgatives, and the stomach 
Btrengthened by some appropriate tonic medicine. A tea 
made from gentian root, dog wood, or wild cherry bark, half 
a glassful before each meal, taken cold, is recommended as 
about the best. Exercise in the open air, whether walking or 
on horseback, is the best ; this should be combined, if possi- 
ble, with agreeable company and constant change of air and 
scene. Travelling is a powerful remedy in this disease, since 
it is often one of the most effectual means in removing indi- 
gestion, of strengthening the body, and exhilarating the spirits ; 
and where the patient's circumstances will permit, it ought 
invariably to be one of the first measures resorted to, as it will 
undoubtedly be found one of the best. The patient should 
accustom himself to early rising, and regular meals of nourish- 
ing and easily-digested food. The bowels are almost always 
torpid in this disease, and will, therefore, require constant 
attention in selecting articles of diet which are of an opening 
quality, such as stewed fruits at meals, ripe fruit uncooked, 
between meals, roast apples after tea, etc, with an occasional 
employment of medicine if needed. 

Regular daily friction over the limbs and bowels, with the 
flesh-brush, is advisable. 

The moral management is of very great importance in this 
disease, for assiduous kindness and consoling conversation pro- 
duce a deep effect. The patient should rarely be opposed in 
the expression of his sentiments, and never with ridicule. A 
rery important object is to gain the patient's confidence, and 
in order to effect this, we must humor his foibles, and seem to 
fall in with his views. When he is dwelling upon some 
imaginary disease, it must be prescribed for, and should his 
anxiety pass in succession from one complaint to another, they 
ought all to be prescribed for in their turn. That is better 
than trying to argue him out of his " notion." 

HICCUF, or HICCOUGH. 

This is an affection too well known to require any descrip- 
tion. It is a sudden jerking spasm of the diaphragm (or mid- 
riff), expelling the air from the lungs with a peculiar sound 



Giddiness. 247 

Acidity of the stomach or eating some article of food which 
disagrees with the stomach is usually the cause of the disease. 
Generally it is a trivial and transient inconvenience, but its 
occurrence in the last stages of acute disease is a grave (often 
fatel) 6ymptom, indicative of aproaching death. There are 
cases however, differing from either of the above ; it some- 
times occurs in the persons, more especially of young females, 
of an hysterical tendency, and may continue for weeks with- 
out cessation, except during the hours of sleep, in spite of all 
kinds of treatment. The causes of ordinary hiccup are gene- 
rally fasting, or some sudden stimulant taken into the stomach, 
such as highly seasoned soup; and the affection generally 
subsides of its own accord. When inconvenient, nothing is so 
likely to remove it as some active emotion of the mind sud- 
denly excited. Startle the patient by slapping on the back, 
clapping the hands unexpectedly behind the head, chase 
around the room as if in pursuit of a rat or mouse, etc. Any 
ihing to engage the patient's mind quickly. The continued 
sipping and swallowing of cold water is a frequent domestic 
remedy, a few drops of pepperment in a glass of water or a 
teaspoonful of soda in a glass of water will often remove it. 
If further treatment is necessary, press firmly on the two col- 
lar hones for a few moments : this will often work like a 
charm. A few drops of laudanum, hartshorn, or paregoric, iu 
water are also good remedies, 

GIDDINESS or DIZZINESS OF THE HEAD. 

There are a few diseases of a simple character, that are pro- 
ductive of more unpleasantness to an individual than a "swim- 
ming " in the head, as it is often called. Some disorder of the 
circulation of the blood in the head is a probable direct cause 
of giddiness, and this is most palpable after persons have been 
confined to bed or to the horizontal position for a short time; 
on first assuming the erect posture, giddiness is generally ex- 
perienced. Intoxication is an example to a certain extent of 
the same thing. A mere passing giddiness is probably owing 
to some cause which a little attention to the state of the 
stomach will correct; but repeated attacks, especially if 
accompanied with palpitation of the heart, or pain and heat 
about the head, indicate danger, and no time should be lost in 
consulting a physician. The treatment of course must be 
according to the cause of the disease. If produced by too 
long application of the mind to any subject or study, leave it 
off, and take recreation. If caused by dyspepsia, reduce the 
diet, and leave off the use of indigestible articles of food. If 



248 Headache. 

costive, take purgatives two or three times a week ; a dose of 
Rochelle salts or a Seidlitz powder on an empty stomach, of 
five grains of blue pill, with five of Dover's powder made into 
a pill at bed time, followed the next morning by the Rochelle 
salts or Sedilitz powder, will have a most happy effect, and 
eat such articles of food as will keep the bowels open, (see 
Hypochondria.) Abstain from the use of coffee, tea, and in- 
toxicating liquors, take plenty of active out-door exercise, 
avoid meats for supper, bathe the head often in cold water, 
and keep the feet warm and dry. 

HE A DA € H E . 

It is scarcely necessary for me to say that it is rnrwise ever 
to neglect headaches. They are sources of great suffering, and 
often lead to serious derangements of the general health. 
Headaches are more common among civilized than uncivilized 
nations, more frequent among females than males, among 
those of sensitive feeling than otherwise, and among the se- 
dentary than those who are more in the open air, or who take 
active bodily exercise. 

Headaches are of various forms, dependent on their various 
causes, such is Plethoric headaches in those who are stout, 
robust, or full-blooded ; sometimes it lasts but a few hours, 
or it may continue for several weeks : 

Sick Headache — so called from the nausea or sickness at the 
stomach, which attends the pain in the head. 

Bilious Headache — occurring most in summer or fall ; it 
effects persons mostly who have dark complexion, dark hair 
and melancholy disposition. Nervous headaches are more 
common among females than males. The pain is usually acute 
and darting, and is made worse by light, and with a feeling as 
if the temples were being pressed together, and a "swimming" 
in the head. I 

There is sometimes a sense of sickness, with a dread of fall- 
ing and great despondency, or restlessness. The bowels are 
generally costive and the sight dim. The pain comes on most- 
ly of a morning and lasts through the day, going off in the 
evening. j 

Besides the above-named varieties, are also Hysteria 
headache, headache from Exhaustion, Brow Ague, Rheuma- \ 
tic headache, &c. 

The great point about these different varieties of headache 
is, that there is a cause for them, if you will but find it out,' 
and most of them therefore can be cui od. Not merely reliev- 
ing the headache when you have it, but preventing tbw recur- 



Headache, 249 

renee of the disease. How many persons with premature grey 
hair, a care-worn and wrinkled face, an oldish look and loss 
of memory, &c, from some form of headache which has lasted 
for years. 

The great point in treating cases of headache, is to find out 
the cause if possible. However, in all cases except in head- 
ache from exhaustion or weakness, or during pregnancy, you 
can safely apply the following remedies : — As soon as it is ob- 
served that a headache is going to "spoil a day's work or stop a 
day's pleasure," take half a teacup full of water as warm as 
it can be comfortably swallowed every fifteen minutes, until 
vomiting occurs, or the headache is abated. Then take a tea- 
spoonful of Hochelle or Epsom salts in a glass of water, or a 
Seidletz Powder, every three hours until the bowels operate. 
When the bowels are opened, the headache will be as a gene- 
ral thing, cured. In most of cases, it will be necessary to live 
on a lower diet for a while, especially in ruddy, stout, robust 
persons who are full-blooded. A shower-bath over the head 
every morning, or a vessel of water poured from a distance, of 
two or three feet above, on the head, in most cases of head- 
ache, is a good preventive remedy. Costweness is a very pre- 
valent cause of the various cases of headache, which must be 
avoided by purgatives and diet. 

Sometimes swallowing the juice of a lemon, in which is mix- 
ed a little sugar, will relieve an ordinary headache in a few 
minutes— or when a lemon is not handy, heating a little vine- 
gar in a sauce-pan, and inhaling the vapor as it rises, up the 
nose, will answer; — or a teaspoonfull of vinegar in a little 
water taken every hour will answer in many cases. For pro- 
curing sleep and rest in cases of headache use the following 
mixture: — Tincture of valerian, one ounce, ^tincture of hyos- 
cyamus (Henbane) one ounce, paregoric, two teaspoonsfull, 
spirits lavender, one ounce. Mix and take a teaspoonfull 
every three hours till rest is procured. 

Persons who are subject to headache in any form, should 
avoid eating between meals, and by all means avoid hearty 
suppers; eating meat for supper, or any indigestible article, 
or a plate of ice cream, just before going to bed, being very apt 
to be followed next day by an attack of headache. Meat, ice 
cream, &c, taken &t proper times, are all good in their place, 
but remember that there is "a time for all things." 



250 Hernia. 

Hernia or Rupture- 
It is highly important that this dangerous affection should 
be understood, from the fact of its frequency, and that it is so 
often badly treated, or not treated at all. By the term Rup- 
ture, we understand a protrusion of any internal organ from 
its cavity or where it belongs ; but the term is generally re- 
stricted so as to mean no more than a protrusion of the bowels 
througli the walls of the belly. If the abdominal walls are 
weak, from any cause, no matter what — lifting, straining, or 
making violent muscular exertion of any kind, will then cause 
the bowel to force itself through at the weakest spot, and push- 
ing the lining of the belly, (the peritoneum,) along before it, 
a bag or sack is formed in which the projecting bowel is en- 
closed, forming an external tumor, lump or swelling. 

Hernia occurs in both males and females, and children are 
often born with it ; or it may occur at any period of life, from 
infancy to old age. 

"Whenever a lump or tumor appears in any part of the bel- 
ly, in the groin, or upper part of the thigh, or vicinity, it 
should at once be attended to. When there is an enlargement 
or fullness of the scrotum or bag, Vakicocele or Hernia 
should at once be suspected. A swelling coming suddenly in 
the groin, or at the navel after considerable exertion, may be 
taken for rupture without much fear of mistake. 

Hernia, or Rupture, is never free from danger until the pa- 
tient obtains a properly constructed Truss — the low-priced 
Truss, which is too often sold in drug stores, &c, being worse 
than none at all. 

Rupture is a very common affliction ; it has been estimated 
that every fourth person is more or less affected. Females, 
from motives of (Jelicacy, are apt to conceal the misfortune, and 
not seek advise — this is wreng ; it exposes them to danger. 

The complaint being discovered, the bowel should be put 
back in its place, and a Truss at once obtained. In the case 
of young persons a Truss will often effect a cure, but that it 
may do this it should be worn night and day, except just time 
enough for cleaning it, &c, and then the patient should be in 
bed. Pieces of old knit stockings are the best to put between 
the pads and the skin, renewed every few weeks. The parts 
should be bathed or washed in cold water night and morning, 
the Truss being removed at the time, and the patient lying 
down until the Truss is put on again. To tell a Rupture from 
Varicocele, let the patient lie down on the back for a few 
minutes, then press with the two middle fingers pretty firmly 
over the region each side of the genital organs, (pubes,) and 



Catarrh in tfie Bead. 251 

rising to the feet to keep up the pressure. If it is Rupture, the 
tumor or enlargement will not mafe ita appearance in the 
scrotum or bag — it it is Varicocele, it will immediately be- 
come full again, and feel like a bag of cords or worms. Per- 
sons who have Rupture must not aMow the bowels to become 
costive, as straining at stool is highly injurious. 

CATARRH IS THE HEAD. 

This disease is usually the result of a cold in the head, which 
through mismanagement, inattention, constitutional predis- 
position, an enfeebled state of the system, a scrofulous taint 
of the blood, or other unfavorable circumstances, runs into a 
chronic state. From this apparently trifling complaint, with 
which every one is forced to make acquaintance, at some sea- 
son of the year or other, is developed a disease as frequent and 
offensive as it is dangerous, and which in its progress is apt to 
affect seriously some of the most important organs of the hu- 
man economy, and to be instrumental in causing the impair- 
ment or loss of smell, taste, or hearing, and even loss of life 
itself. This disease is popularly recognized by the name of Ca- 
tarrh in the head. 

The first sensation is usually a feeling of dryness and heat 
in the nose, and a frequent inclination to sneezing. There is 
an inability to breathe freely, as the nose becomes stopped up, 
sometimes on one side, sometimes on the other. 

Soon a clear, watery, irritating discharge makes its appear- 
ance, excoriating the nostrils and edges of the lips, which 
becomes red and somewhat swollen. After a few days the dis- 
charge becomes thick, yellowish, extremely frequent, and 
continues to be a marked feature of the disease, and a source 
of much danger and the greatest annoyance. After more or 
less time, it becomes thick, very disagreeable, and assumes an 
extremely offensive odor. It is usually so profuse as to re- 
quire, when confined to the nose, the frequent application of 
the handkerchief, or if it drops into the throat, which is more 
particularly the case, while laying down, a constant coughing, 
and sometimes both. 

Sleep is frequently disturbed by a sensation of choking, 
caused by the presence of the discharge in the throat. Owing 
to the heat in the head, the watery portion of the discbarge 
often evaporates, and, assuming a condition of solidity, is de- 
posited upon the membrane of the nose and upper part of the 
throat, in the shape of crusts or hardened lumps. The accu- 
mulation of these incrustations produces a feeling of discom* 
fort, and narrows the passage so as to embarrass respiration. 



252 Catarrh in the Head. 1 

Therefore, frequent efforts have to be made to remove tliem, 
either by forcibly blowing the nose or by persistent hawking. 
During sleep these incrustations accumulate more rapidly, and 
the feeling is therefore most uncomfortable in the morning. 
Sometimes all efforts to clear the throat are futile until after 
breakfast, or after something warm is swallowed. The dis- 
charge, which is at first without smell, assumes in the progress 
of the complaint an excessively offensive odor, the breath par- 
ticipates in this, and becomes occasionally so revoltingly offen- 
sive as to render the patient an object of disgust to himself as 
well as to others. Ulceration of the mucous membrane of the 
Qose takes place occasionally. The accumulation of the dis- 
charge, together with the thickened condition of the mucous 
membrane, renders breathing through the nose very difficult, 
and oftentimes impossible, necessitating respiration principally 
through the mouth — a method very deleterious to the general 
health, but more particularly so to the lungs. Sometimes the 
voice loses its musical quality, and assumes a discordant, harsh 
and nasal character ; the sense of smell becomes much im- 
paired or entirely lost, and the same effect, though less 
frequent is produced on the sense of taste. Occasionally, 
while blowing the nose, a crackling or bubbling sound will be 
heard in the ear, and hearing will be found quite thick and 
stopped up, but returns suddenly with something like a snap- , 
ping sound. This is sometimes repeated, until, at one time, \ 
hearing does not return, and remains permanently injured. ! 
Noises in the head of every conceivable description will inake 
their appearance and add to the distress of the sufferer, and '■■ 
hearing may be lost so gradually that a considerable degree | 
of deafness may exist before the person is really aware of the 
fact. The eyes are apt to become weak, irritable, and disposed 
to water on exposure to cold and wind, or after the slightest ' 
exertion. A pain, more or less acute, or a distressing feeling 
of pressure is experienced over the eyes, and sometimes on the 
top or back of the head, and also pain in the face, closely re- 
sembling neuralgia, for which it is very often mistaken. The 
distress in the head weakens the memory and produces irrita- 
bililty and moroseness of disposition. The stomach generally 
suffers more or less, is weak and irritable ; the appetite is va- 
riable, and is nearly always bad in the morning. In severe 
cases, the system becomes feeble and prostrated, and there is 
an aversion or inability to either physical or mental exertion. 
Not unfrequently catarrh proves fatal, either by debilitating 
the system and wearing out the patient, or by traveling down- 
ward and producing throat affections, bronchitis, and finally 



Catcurrh in the Head. 253 

consumption". It may be safely asserted that after hereditary 
predisposition, catarrah is the most frequent and important 
cause of this fatal complaint. 

The symptons of catarrah vary considerably in different in- 
dividuals, and the degree of their severity depends upon con- 
stitutional peculiarities and various external influences. With 
some the complaint continues for a number of years in a mild 
form without causing any of the injurious results above de- 
scribed, while with others all the worst effects are produced in 
a very short space of time ; and cases, apparently most harm- 
less, may, through imprudent exposure, additional cold, or 
unfavorable changes of the weather, suddenly exhibit all the 
violence and malignity which characterizes the severest ones. 

In the treatment of this disease but little can be done with- 
out medical treatment by a physician who can take into con- 
sideration the age, occupation, how long the disease has existed 
the condition of the general system, &c. The author of this 
work has had extensive experience in the treatment of this dis- 
ease during the last few years, having treated patients from 
most of the States of the Union ; and I was led to examine 
very closely into its nature, and the best treatment adopted 
thereto ; and having seen tried the various popular " Catarrh 
Remedies " sold by those who knew nothing of medicine, as 
well as the usual treatment of the medical profession, without 
satisfactory results, I came to the conclusion that the inhala- 
tion of medicated vapors was the best treatment. I invented an 
Inhaler, which is now extensively used by the profession. 

If you cannot get one of the Inhalers in your town, you must do 
the next best thing you can, dropping a few drops of Olive Oil, or 
oil of Sweet Almonds, into the nostrils three times a day, by laying 
down on the back, lowering the head and letting the oil find its 
way to the throat, is a valuable remedy. A gargle made of strong 
Sage tea, one pint ; Borax, half an ounce ; Honey, two ounces ; 
to be used cold, about every three hours, stooping the head forward 
and letting some of the gargle pass out at the nostrils, is a good 
remedy. (A description of the system of Medicated Inhalation, 
&c, will be found on page 500. ) The bowels should be kept open, 
and build up the system by giving bitter tonics, such as a wine 
glass of tea made from Wild Cherry Bark ; or Tincture of Columbo, 
one teaspoonful in water, before each meal. Avoid us ng irritating 
washes, gargles, &c, as they often do much harm. 



254 Spitting of Blood, 

SPITTING OF BLOOD. 

This is a more serious discharge of blood than is generally 
supposed, and many cases of this kind suffered to linger along 
unattended to, terminate in consumption. The discharge is of 
a bright red color, brought up by hawking and spitting, fre- 
quently preceded by a saltish taste in the mouth, a sense of 
heaviness about the heart, difficu]t and painful breathing, and 
dry, tickling cough. It differs from blood brought from the 
stomach, that from the latter is of a more dark and clotted ap- 
pearance. It most commonly occurs at ages from fifteen to 
thirty, and may be occasioned by any violent action of body 
or mind : by the suppression of accustomed evacuations : by a 
rarified aiK^ and most frequently takes place in persons of long 
necks and narrow chests : often in families subject to similar 
complaints. ■ 

Bleeding from the lungs may occur in every degree, from a 
mere tinge of the expectoration, to the copious coughing up of 
fluid blood. The blood is couyhed up, whereas, when it cornea 
from the stomach, it is vomited, a distinction which appears 
evident enough, but which is not always readily made in prac- 
tice. The management of hemorrhage from the lungs must be 
that recommended for hemorrhage generally. Until medical 
assistance can be procured, perfect quiet is to be observed, cool 
air, especially on the chest, freely admitted, and cold, or iced 
and acidulated drinks given plentifully. Alum will also be 
found useful ; either letting it dissolve in the mouth and swal- 
lowing it, or dissolving a teaspoonful in a little water, and tak- 
ing it as may be needed. Should the attact continue and med- 
ical assistance still be absent, cupping on the chest, or between 
the shoulders, might be had recourse to : or in an extreme 
case, when medical aid is far distant, one grain and a half 
of sugar of lead may be given, made into pill with crumb 
of bread, every two, or three, or four hours, being washed 
down by a draught of vinegar and water. The expressed juice 
of the common nettle is sometimes popularly used, and, it is 
said efficaciously, to check bleeding from the lungs ; the dose 
is one teaspoonful three times a day. The inhalation of the 
smoke from the burning leaves of the belladonna is said to 
check the immediate flow of blood from the lungs. For this 
purpose one teaspoonful of the cut and dried leaves is to be 
thrown upon live coals, and the fumes inhaled. Another val- 
uable, because such a ready means of checking bleeding from 
the lungs, is to eat freely of salt, or drink salt and water every 
ten or fifteen minutes. When there is troublesome cough, it 
should be relieved by thirty or forty drops of paregoric, given 



Typhus Fever. 255 

occasionally, as required. Persons of scrofulous constitution, 
or who have any malformation (imperfectly formed) of the 
chest, are most liable to suffer from it. It rarely occurs in 
children. The exciting causes of this form of hemorrhage are 
such as call the lungs into active, strong, or continued exer- 
tion, such as violent bodily movements, much loud exercise of 
the voice, playing on wind instruments, &c. ; these things 
must therefore, be sedulously avoided by those who have any 
tendency to the disorder. Temperance and moderation, strict 
attention to the condition of the bowels, and to all things ne- 
cessary to preserve health, as detailed in the first part of this 
work, will be necessary. While treating of this subject, it 
should be mentioned that persons are often needlessly much 
alarmed, from thinking they are expectorating blood, while 
the fluid simply comes from the throat or gums, or, it may be, 
is the consequence of blood from the nose trickling down the 
back of the throat. To test the matter, a slight attempt at 
coughing should be made ; if the bleeding is not from the 
Lungs, there will be no fresh blood coughed up. 

TYPHUS OR TYFHOYD FEVEB. 

This has been called by different names, such as malignant 
fever, continued fever, slow fever, &c. ; but for all practical 
purposes, in a work like this, we prefer the name most famil- 
iar with the people, so they will better understand our mean- 
ing. This is an affection of the whole system, and by medical 
men is subdivided into several types or forms : but it would 
serve no good purpose to enter into these here. The manage- 
ment of a disease so gravely important as fever can never be 
legitimately undertaken by unprofessional persons, if medical 
assistance is procurable ; but as a provision for circumstances 
when this is absent, the less complicated the account both of 
che disease and its treatment, the more likely it is to be man- 
aged with advantage. The first symptons of incipient fever 
are usually displayed through the nervous system. The indi- 
vidual feels an unaccountable languor, and complains of head- 
ache and shivering, cannot exert his powers either in the du- 
ties or pleasures of life, is easily tired, sleep is disturbed, the 
appetite is impaired, the skin looks dusky and the eyes heavy, 
the pulse quickens, and at length the f eeling of general illness 
drives the patient to bed. The attack, however, may com- 
mence much more suddenly — a shivering, or, as the people in 
many places call it, an " ague fit," may be the first sympton ; 
or severe headache, or vomiting, or fainting, or even convul- 
sion may be the first symptom of the impending malady. 



256 Typhus Fever. 

When fever is fairly established, the pulse ranges above 100 
the tongue is furred, probably brownish and dry, sleep is dis- 
turbed or supplanted by delirium, the muscular power is 
diminished, and the mind indifferent to passing circumstances ; 
dark incrustations collect about the teeth ; the patient sinks 
down in bed, and perhaps passes the natural evacuations un- 
consciously, thus displaying the most evident signs of debility. 
This condition may increase till it terminates in death, or 
tends toward recovery, either by some marked crisis, such as 
profuse perspiration, or by an almost imperceptible amend- 
ment. Tranquil sleep, improved aspect 01 the countenance, 
the skin cooler and with more tendency to moisture, the 
tongue cleaning at the edges, and a natural desire for food, all 
give signs that the disease is passing away ; on the other hand, 
if a fatal isssue is approaching, the general weakness increases, 
the patient slips down in the bed in consequence, and lies in a 
state of dreamy muttering ; there is convulsive starting of the 
fingers or other parts 01 the body, picking at the bedclothes, 
the insensibility to external impressions increases, and proba- 
bly stupor closes life. 

The above are the general features of fever, whether simply 
continued, or when it runs out to the more serious forms of 
typhoid, low, nervous, or typhus fever. There are many other 
indications which occur, but which it would serve no good 
purpose to detail here ; all that is required is that the disease 
should be recognizable, so that *ts general management may 
be properly and unintelligently conducted when it falls to the 
lot of an unprofessional person to have the direction. 

In the first place it must be remembered, that for continued 
fever we have no cure, that is, we have no medicine which we 
can give with the tolerable certainity of removing the disease, 
as quinine removes ague : it must be vanquished by the pow- 
ers of the constitution, by the tendency to health, and our 
endeavor must be to place these powers in the most favorable 
condition possible for the struggle, and where they appear to 
be insufficient, assist. Sometimes the constitutional power 
will throw off fever at the very onset. 

Probably few medical men have not experienced in their 
own persons, when attending fever patients, that they had 
contracted the disease, and that after all its symptoms had 
been in course of development for four-and-twenty, or even 
eight-and-forty hours, it has been cast off, probably, by per- 
spiration or diarrhoea, and health restored. From this almost 
ephemeral attack, to the week after week of continued fever, 
the disease may be thrown off at any period of its course. A 



Typhus Fever. 257 

person attacked with fever ought to be placed in as roomy and 
well-aired a situation as possible — better even in a barn than 
in a close or crowded room ; the greatest cleanliness as regards 
everything around must be observed, and perfect quietude ; if 
thirst is present, it should be liberally indulged with simple 
acidulated drinks, such as lemonade and toast-water, mixed; 
flax-seed tea, cold, &c. ; if nourishment is taken, it should be 
given in modern quantities, and consist principally of milk 
and farinaceous preparations, corn starch, farina, or grapes, 
oranges, and ripe fruits, if they do not create flatulence or diar- 
rhoea, are allowable. If the skin is hot or dry, it should be 
sponged with water ; this practice is beneficial, more or less, 
in most cases. By these simple means of management, almost 
without medicine, beyond some gentle purgative, as castor oil, 
&c, at intervals, to keep the bowels perfectly free of their ne- 
cessarily depraved contents, many a case of fever may be well 
conducted to a favorable issue, with much more certainty than 
under a more meddlesome treatment-— care being taken when 
signs of amendment show themselves, that there is not too 
great hurry in giving or permitting strong nourishment. 

In more serious forms of fever, the same principle of treat- 
ment must be kept in view, but more urgent symptoms may 
call for more active interference ; violent delirium may require 
the treatment pointed out under the article devoted to the sub- 
ject ; difficulty of breathing and cough may render a blister 
on the chest desirable, or tenderness of the bowels on pressure, 
particularly in the right lower side of the abdomen, near the 
hip bone, may call for the application of half a dozen leeches. 
Diarrhoea may require to be checked, by small doses of pare- 
goric, or drinking occasionally a wine glassful of allspice tea, 
with a little prepared chalk in it, or constipation removed by 
gentle aperients ; castor oil or rheubarb or senna will general- 
ly be found safest and best, or injections of weak soap-suds. 
Sleeplessness at night, with convulsive starting of the fingers, 
may require laudanum, ten to forty drops ; or the general 
sinking of the powers, the pulse becoming feeble and easily 
extinguished, may call for the administration of wine or bran- 
dy in teaspoonful doses, every hour or two, according to 
symptoms, with strong meat-broth, or gravy, in frequently re- 
peated small quantities. At this time care must be taken 
to observe whether urine is passed ; if there seems to be diffi- 
culty, a bag of hot bran on the lower part of the body will 
possibly make it easier ; if it dribbles away, means should be 
taken to protect the back and hips of the patient from being 
wetted with it. This may be done in varions ways, either bj 



258 Typhus Fever. 

waterproof material, or by constant renewal of dry cloths ; it 
is much better effected, however, by bags of bran, or a sponge 
so placed as to absorb the urine as it comes away. If with 
every quart of bran, four ounces of the diluted sulphuric acid 
be mixed, it will neturalize the ammoniacal emanations which 
so quickly arise wherever urine collects. 

It is often the case, that patients who lie long in fever be- 
come liable to bed-sores, or ulcerations on the prominent parts 
of the body which are subject to pressure as they lie ; these 
are, especially the back and hips, points of the shoulder-blades, 
back of the head, tips of the ears, &c. When these ulceia- 
tions form, they not only add materially to the sufferings of 
the patient, but may become the cause of a fatal termination 
to a case that might otherwise have recovered. They should, 
if possible, be prevented. The parts named above should be 
frequently examined, and on the slightest appearance of red- 
ness, the skin at the spot should be rubbed with whiskey, bran- 
dy, bay rum, or spirits of camphor. When the skin has ac- 
tually broken, it may be dressed with simple spermaceti 
ointment spread on linen ; lead plaster spread on soft leather 
is often useful, (see directions for making under head of " Me- 
dicines,") or the white of egg beat up with alum. Both as a 
preventive and as a remedy after the sores have formed, the 
parts should be relieved from pressure as much as possible by 
various arrangements of cushions, &c, the elastic ones made 
for the purpose being the most suitable. 

The foregoing are the general principals on which a case of 
fever is to he managed / by attention to them an unprofessional 
person will be much more likely to do good than by meddlesome 
interference. Attention to the ventilation of the room, to the 
perfect cleanliness of the patient and of every thing around — 
free supply of diluent drinks, as previously stated, and care 
that the bowels are duly, but not forcibly relieved of their 
always depraved contents, ought to constitute the chief re- 
sources of the domestic management of fever. 

Again it is repeated, fever is not a disease to be curedy but 
to be guided to a safe termination. 

In regard to the causes of fever, they may be enumerated 
as follows : Predisposing — whatever lowers, either temporarily 
or permanently, the standard of the general health ; and 
Direct— contagion and the products of animal or vegetable 
decomposition. 

Attention is called before closing to the employment of 
fresh yeast in cases of fever, particularly of a low, malig- 
nant or putrid tendency, :n which it is most useful. It is 



Typhus Fever. 259 

given in tablespoonful doses, repeated every three or four 
ours. 
It should also be borne in mind in the treatment of these 
fevers, that the patient should be allowed to partake freely of 
gum arabic dissolved in cold water ; or slippery elm water, 
adding a few drops of spirits nitre occasionally. Also let him 
have a piece of some pleasant bark, root, or herb in his mouth 
constantly (if agreeable) to chew on; it promotes the flow of 
saliva or spittle, and saves much suffering from dryness of the 
mouth. A piece of orange or lemon peel, sassafras root, an- 
gelica root, dogwood bark, or things of that kind, are admis- 
sible. When in the course of the disease there is a tendency 
to sinking, do not be afraid to give one or two grains of 
quinine every three or four hours, to be given in smaller doses 
or left off entirely if much headache should follow its use. 

In the early period or forming stage of this disease, an 
emetic will often be found advantageous. A dose of ipecac 
may be administered, and its operation promoted by giving 
the patient large quantities of weak camomile tea or warm 
water. After the patient has rested from the effects of the 
emetic, a dose of castor oil should be administered, and fol- 
lowed by purgative injections if necessary. The purgative 
should be again repeated, after a short interval, provided tho 
first dose has not the effect of producing full and free evacu- 
ations from the bowels. When these are obtained, they re- 
lieve the oppression of the stomach ; render the tongue clean 
and soft, mitigate the thirst and restlessness, and the morbid 
heat of the surface, and prevent that formidable oppression of 
the brain and nervous system upon which the symptoms of col- 
apse, which attend the second stage of the disease, depend. 

Whenever the symptoms of excitement run high, the patient 
feeling hot and restless, and the skin being universally and 
steadily above the natural temperature, and at the same time 
perfectly dry, no remedy has been found to act with so much 
promptitude, and to be productive of greater benefit, than the 
application of cold water to the surface of the body. It may 
be used in the form of ablution, or sponging ; the patient is 
then to be wiped perfectly dry, and covered up in bed ; after 
which a bowl of warm tea or thin gruel is to be given him. 
It can only be employed, however, during the height of the 
fever, when the heat of the skin is steadily above the natural 
temperature, and no tendency to perspiration is present. 
When the head is much affected, cold should be applied to 
the scalp in the same manner as was directed in bilious fe7«r 



260 Yellow Fever. 



YELLOW FEVER. 



This is a disease peculiar to warm climates, and is mc»re 

Erevalent, and in the worst form in proportion to the greater 
eat of the season ; however, heat alone is not sufficient to 
produce yellow fever. It is attended with great diversity of 
symptoms in different cases. In some patients it commences 
with symptoms which would appear to indicate a perfectly 
mild disease. In general, it attacks suddenly, with a chill, 
pain in the head, back and limbs, and occasionally with a 
nausea or vomiting. The eyes appear red and inflamed, and 
feel hot and painful, the pupils are sometimes dilated, but 
more generally contracted. The chill is commonly of verv 
short duration ; as it goes off, the pulse becomes, in general, 
full and quick, the skin very hot and dry, the face flushed, 
the eyes red and watery. The face has an expression similar 
to that of a person intoxicated ; there is great oppression and 
tightness at the pit of the stomach, with constant restlessness 
and frequent sighing ; the bowels are costive, the tongue white 
and coated, or of a bright red color. The heat of the skin and 
pains in the head and limbs augment rapidly during the first 
thirty-six hours, and then gradually decrease, so that at the 
end of the third day there is either a very great remission of 
symptoms, or even complete intermission of the disease, ter- 
minating in the recovery of the patient. When an imperfect 
intermission only takes place, it is in a few hours succeeded 
by pain and a sense of burning in the stomach, constant nau- 
sea, with efforts to vomit, discharging at first only a little 
thick green mucus. The puke is now small, quick, and irre- 
gular ; the stomach sore to the touch, the bowels costive or 
griped, and the tongue brown and dry. The symptoms 
rapidly increase, until at length the sense of heat and pain of 
the stomach cease, and vomiting of a black, flaky matter, re- 
sombling coffee-ground, takes place, called " black vomit." 
The patient now often feels quite easy, thinks he is getting 
better, rises out of bed and walks about, but soon becomes ex- 
hausted, and falls into convulsions, or into a state of lethargy, 
terminating in death. Some patients become drowsy, awd 
die without a struggle ; in others, death is preceded by the 
discharge from the mouth, nose and ears, of a dark-colored 
blood. The skin of most becomes of a bright yellow before 
the black vomit occurs. In some instances which terminate 
fatally, there is no vomiting of black fluid at any period of the 
disease. 

The predisposing and exciting causes of yellow fever are the 



Yellow Fever. 261 

same as in other fevers : namely, exposure to heat, fatigue, 
cold, intemperance, fear, anxiety, etc. 

In regard to the treatment of yellow fever, this must vary 
according to the stage of the attack, and the violence of the 
symptoms by which it is attended. In the early or forming 
period of the disease, marked by a slight disorder of the 
stomach, headache, pains in the limbs, lassitude, and a sense 
of chilliness, much advantage may be derived from the use of 
the warm bath, brisk frictions of the surface, and the adminis- 
tration of calomel, followed in the course of a few hours by 
castor oil, ten to fifteen grains ; injections of soap suds also 
will be beneficial in procuring a speedy evacuation of the con- 
tents of the bowels. At a later period of the disease, when 
all the prominent symptoms are fully developed, when there 
is heat of the skin, burning pain and sense of distress at the 
stomach, with soreness upon pressure, a mustard plaster ap- 
plied for a few minutes at a time, every hour, will often afford 
relief: or leeches or cups may be applied over the stomach. 

Cold water applied to the surface during the height of the 
fever, by sponging, should never be neglected. It is among 
the most powerful means we possess of reducing the violent 
excitement by which this fever is attended. When the head 
is much affected, after the application of leeches or cups to 
the temples or nape of the neck, keeping the head constantly ' 
wet with cold vinegar, water, or the application to the shaved 
scalp of a bladder partly filled with powdered ice, will be pro- 
ductive of the most decided benefit. 

The thirst of the patient is to be quenched by small and 
repeated draughts of some cold beverage: iced water or 
lemonade, toast or barley water, with the addition of ice, will 
be found among the best. In cases attended with great irri- 
tability of the stomach, we know of no remedy from which 
more advantage will be obtained than from a teaspoonful of 
powdered ice occasionally repeated. 

It is to be recollected, that the foregoing remedies are only 
adapted to the first stage of the disease, and if judiciously and 
vigorously employed, the danger of the second stage will be 
avoided, and the most unpleasant symptoms diminished within 
the first twenty-four hours. 

In the second stage of yellow fever, our hopes of arresting 
the fatal progress oi the case are but slender. The same treat- 
ment as to the gum arabic and slippery elm water, for cooling 
drinks, etc., also, the quinine, when symptoms of sinking 
appear, which was recommended in typhoid fever, is as appli- 
cable in yellow fever. In fact, I would recommend in th* 



262 Vomiting of Blood. 

very beginning, as soon as the bowels have been opened, to 
give a mixture composed of two grains of quinine, five grains 
of powdered charcoal, and one grain of powdered sassafras 
bark, to be repeated every two hours. This will not interfere 
with the other treatment, and will by its power of keeping up 
the strength on the one hand, and its antiseptic properties on 
the other, be well worthy a trial. 

TOMIT12TG OF BLOOD. 

This is usually preceded by a feeling of heaviness and pain 
about the stomach, but without cough. Generally it is pre- 
ceded by nausea, loss of appetite, etc. There is often pain or 
uneasiness in the left side, with anxiety and a sense of tight- 
ness in the chest. The blood discharged is generally dark 
colored, clotted, and often mixed with some of the contents 
of the stomach. In some cases there is also a discharge of 
dark colored blood by stool. The amount of blood vomited 
is various. Sometimes a large quantity is thrown up at once, 
when the disease ceases, and does not again occur; but in 
general the vomiting is repeated at short intervals, until the 
patient is completely exhausted. Yomiting of blood may 
occur in persous of a full habit and robust constitution, but is 
most common in those who are weakly, or who have labored 
for a considerable time under a disease of the digestive 
organs. 

The most frequent causes appear to be grief, or other de- 
pressing or violent passions ; costiveness, especially if occur- 
ring in a constitution in which the stomach is particularly 
irritable ; blows on the region of the organ atfected ; fullness 
of habit, combined with an intemperate mode of life ; the use 
of intoxicating drinks ; the suppression of the menstrual flux, 
or of the discharge from bleeding piles ; acrid or irritating 
substances taken into the stomach, and the abuse of emetics 
and active purgatives. 

It is, in general, easily distinguished from spitting of blood, 
by the blood being here brought up by vomiting, and by its 
being of a darker color. It is also generally mixed with some 
ef the contents of the stomach. In spitting of blood, on the 
contrary, the fluid discharged from the lungs is brought up 
by hawking or coughing, and is generally of a bright red 
color. 

When a person is attacked with vomiting of blood, he 
should be kept perfectly quiet, in a room, the air of which is 
rather cold than warm, aiid his dress should be loosed so ad to 
prevent % 9&j pressure upon the stomach. If the complaint 



Vomiting of Blood. 263 

occur in a person of a full habit, and possessing considerable 
general strength, cups or leeches should be freely applied over 
the stomach. In cases occurring in debilitated habits, or 
where the discharge of blood has already lowered considerably 
the strength, cups alone over the stomach will be proper, and 
these should be applied without scarifying. 

If the bowels are costive, they should be opened by an in- 
jection of warm water mixed with thin gruel and a little soap 
suds. The thirst in this complaint is always considerable ; it 
may be allayed by the patient taking small quantities of gum 
arabic, slippery elm, or toast water perfectly cold. In many 
cases where vomiting is incessant, advantage will be derived 
from the administration of an occasional spoonful of iced 
water, or even of powdered ice. 

When the vomiting of blood has been produced by suppress- 
ed menses or a cessation of the discharge from bleeding piles, 
leeches should be applied about the upper part of the thighs, 
or to the anus (outlet of the bowels) — the patient's feet should 
be immersed in hot water, to which salt or mustard has been 
added, and afterwards mustard poultices applied to the ankles. 
If it be necessary, from the great discharge of blood, promptly 
to put a stop to the vomiting, twenty-five grains of ipecac 
should be taken, in a little warm water, and if the first dose 
fail to stop it, a second may be administered after an interval 
of two or three hours. Ipecac is frequently of very great ser- 
vice in this complaint. It is applicable to the case of strong 
as well as of weakly persons. 

Sugar of lead is, in many cases, a medicine of great value 
here, as well as in other profuse bleedings. Combining 
it with the ipecac is often advantageous : we may give two 
grains of the sugar of lead with two of the ipecac. Calomel 
in grain doses, every two hours, will in some instances speed- 
ily arrest the vomiting ; it should be given combined with five 
grains of gum arabic, and mixed with a little water. 

After the blood has ceased to flow, and the patient begins 
to recover himself, the further treatment of the case will de- 
pend in a great measure upon the nature of the symptoms 
which remain. The occasional application of cups or mustard 
plasters to stomach will still be demanded, in most cases. 

The diet recommended under Dyspepsia mH ; in general, 
bo the most proper. 



264 Dropsy, 

DBOPSTi 

The disease to which the term dropsy is most usually appli- 
ed, is that general swelling over the whole body, of a soft and 
doughy feel, accompanied with great weakness, and other 
symptoms to be hereafter described ; or it is that swelling of 
the belly, from the accumulation of a watery fluid within, by 
which it is often distended to a prodigious size. 

General Dropsy is a swelling of the external parts of the 
body, from a collection of fluid chiefly under the skin ; the 
swelling first appearing on particular parts only, but at length 
gradually extending to the whole surface. The swelling in 
dropsy is always soft and uniform over any member ; and 
when pressure is made upon the skin with the finger, a pit or 
hollow is formed by the water being pressed out of some of 
the cells beneath, into the neighboring ones. Soon after the 
pressure is removed, the swelling returns to its former full- 
ness. Generally, the swelling appears first on the lower ex- 
tremities, and that only in the evening; it is seldom, at an 
early period of the disease, very perceptible in the morning. 
The more a person has been in the erect posture through the 
day, the greater is the swelling towards evening. It is easy to 
be seen, that this is owing to the water making its way down- 
wards by its own weight ; while the posture during sleep 
allows it either to diffuse itself equally over the whole body, 
or if the quantity be great, and the disease far advanced, to 
accumulate in the upper parts of the body, and to occasion the 
swelled face, and closed-up eyes, which some dropsical pa- 
tients exhibit in the morning. Sometimes the fluid which is 
accumulated immediately under the skin, oozes out through 
the pores of the skin ; sometimes being too thick to do so, it 
raises the outer skin in blisters. Sometimes again, the shin 
not allowing the water to pass through it, is hardened by dis- 
tention, and gives the swelliag an unusual degree of firmness. 
General dropsy is almost always attended with scantiness ol 
urine, which is generally high-colored, and after cooling, lets 
fall a copious reddish sediment or settlings. There is also an 
unusual degree of thirst ; the appetite is generally bad, and 
there is a feeling of debility, with sluggishness, drowsiness, 
and disinclination to motion. 

Exhausting diseases of various kinds, copious and long con- 
tinued discharges of blood, or any other weakening cause, may 
produce a debility of the system, which leads to dropsy. In- 
temperance in the use of strong liquors, especially dram-drink- 
ing, is one of the most common, intractable, and fatal cause* 



Dropsy. 265 

of dropsy. Profuse bleeding has been already mentioned as 
causing general debility, and as producing dropsy. 

From the account given of the causes of dropsy, it is evident 
that, while they continue to act, it will be useless to attempt 
carrying off the accumulated fluid, and therefore one of our 
first objects must be to put a stop to these causes. In a dram- 
drinker, or an indolent, debilitated person, it will be in vain 
to give drugs, or to direct any particular diet, however salu- 
tary, till these bad habits are given up. We are next to 
attempt to get rid of the water already accumulated. Some- 
times very strong purgatives, particularly those which produce 
large watery stools, procure a very rapid discharge of the ac- 
cumulated fluid ; of this kind are gamboge, scammony, and 
the like; or jalap in combination with aloes, scammony, gam- 
boge, or cream of tartar. A powder for this purpose may 
consist of eight grains of aloes, ten of jalap, and six of gam- 
boge or scammony, to be taken in a bolus, or suspended in 
syrup or mucilage, to be repeated, if necessary, every two or 
three days. Or ten grains of jalap, with a teaspoonful or two 
of cream tartar, may be used, given in a wine glass of cold 
water, on an empty stomach. Another class of remedies much 
used in dropsy, are medicines that act on the kidneys, and 
could we insure the success of their operation, we should be 
better pleased to carry off the dropsical waters in this way, than 
by any other method whatever. Cream of tartar is perhaps, 
one of the best diuretics in general dropsy. Dissolve a large 
tablespoonful of cream tartar in half pint of water, and take a 
tablespoonful of the mixture every hour or two. Or mix one 
tablespoonful of spirits nitre with half pint of water, and take 
one tablespoonful every two hours. 

It is an important improvement in the cure of dropsies, that 
the patient is not restricted in the quantity of fluid which he 
chooses to drink, but that a plentiful allowance of watery li- 
quors is considered rather conducive to a cure, by convey- 
ing to the kidneys any diuretic we mean to employ, and even 
as of itself greatly promoting their action. Friction is another 
means of promoting the action of the absorbents ; and exer- 
cise, if the patient can take it, may have the same effect ; and 
when the swelling is abated in the morning, skilful and equa- 
ble bandaging (commencing at the toes and going upwards to 
the knees, or further,) will prevent the swelling of the legs 
towards night. When by these or other means, we have man- 
aged to get rid of the water already effused, our next object is 
to prevent its re-accumulation ; and by strengthening the sys- 
tem, to complete the cure of the disease. Exercise, and the 



266 Asthma. 

proper regulation of the diet, are important items in this plan ; 
and are to be accompanied, in the debilitated, by tonic medi- 
cines, as Peruvian bark tea, (one tablespoonful of the bark to 
half pint of hot water,) of which take, when cold, one third of 
this mixture before each meal. Or the tea of wild cherry bark 
may be given in the same way. Great attention is to be paid 
to the state of the bowels, to keep them open and free ; and 
we must not neglect to keep up a proper action of the skin 
and of the kidneys, by wearing flannel next the skin, and giv- 
ing some water-melon seed tea, occasionally through the day, 
or a few drops of spirits of nitre in a little water, three or four 
times a day. Also bear in mind that the sponge-bath of salt 
and water, over the entire surface of the body and limbs, once 
a day, to be followed by a rough towel and flesh brush, must 
not be neglected, and should be continued for two or three 
months. 

ASTHMA, OR PHTHISIC. 

This disease is an affection of the lungs, which comes on by 
spells, roost generally at night, and is attended by a frequent, 
difficult, and short respiration, together with a wheezing noise, 
tightness across the chest, and a cough ; all of which symp- 
toms are much increased when the patient is lying down. 

Changes in the weather, peculiarity of situation, errors in 
diet, anxiety, fatigue, mental excitment, may any of them 
produce a paroxysm of asthma in the predisposed. Tbe at- 
tack itself is indicated by feelings of indigestion and flatulence, 
headache, chilliness, languor, and drowsiness. After having 
experienced these sensations during the day, the asthmatic 
individual is probably awakened from his first sleep by a dis- 
tressing sensation of constriction of the chest ; he is forced to 
sit up in bed, laboring for breath, or, it may be, to seek an 
open window. The distressed state of the breathing, if not 
relieved by remedies, continues for some hours, and at last 
gradually subsides; the characteristic wheezing becomes less; 
the cough, almost impossible before, is now brought out, and 
sleep, never more welcome, comes on. The latter stage of the 
paroxysm of asthma is generally accompanied with expectora- 
tion of mucus — sometimes it is not ; and upon this a distinction 
into dry and humid (or moist) asthjna is founded. Confirmed 
asthmatics have a distressed cast of countenance, and acquire 
a peculiar rounding or elevation of the shoulders, perfectly 
1 characteristic. Asthma may occur at any period of life, but 
is more general about the middle ; and men are more com- 
monly the subjects of it than women. The remedies are 
various; what gives immediate and full relief to one person 



Asthma. 267 

totally fails in another. The practice of smoking the leaves 
and stems of stramonium, or thorn-apple, is now extensively 
and popularly resorted to ; with some it succeeds admirably ; 
to other it seems to be hurtful ; it may be tried. iEther and 
laudanum, is a favorite combination ; half a teaspoonful of the 
former along with twenty drops of the latter being given in a 
wine-glassful of water. A teaspoonful of hartshorn may be 
•ubstituted for the aether, but is not so efficacious. Twenty 
grains of powdered ipecac, given in half a wineglassful of 
water, to act as an emetic, may be of service, particularly if 
the attack has come on after a full meal, or if there is any 
suspicion of the stomach being loaded. Some experience 
much benefit from strong coffee, drank without milk or sugar. , 
The inhalation of chloroform, a few drops sprinkled on a pock- • 
et-handkerchief, has lately been found to afford relief; the 
fumes of burning nitre (saltpetre) diffused through the air of | 
the apartment, by means of pieces of blotting-paper dipj^d in 
a thorough solution of the salt, and dried, is also useful. One • 
of these, about the size of the hand, ignited and placed upon 
a plate in the room, quickly diffuses its fumes throughout the 
apartment. When there is great dryness and deficient expec- 
toration, steam from bitter herbs, (as in catarrh in the head,) . 
inhaled either simply or with a few drops of sulphuric aether, 
is worth a trial. If there is much acidity of stomach, ten or 
fifteen grains of carbonate of soda with a teaspoonful of harts- 1 
horn in a little water should be given. Indeed, when an 
attack of asthma is threatened or has come on, care must be 
always taken, as far as possible, to remove any existing dis- 
ordered action. A cup of warm tea and retirement to a warm 
bed will remove the chilly sensation. Costiveness of the 
bowels ought to be relieved by a gentle dose of castor oil, or ; 
of rhubarb and magnesia; flatulence or acidity is corrected 1 
by a mixture of water, in which some essence of peppermint 
and prepared chalk have been put, given every hour. Flatu- 
lence particularly must be obviated, and all sources of it 
avoided. Effervescing draughts, soda-water, and such-like, 
are almost always hurtful. The effects of situation and of 
atmospheric peculiarity upon asthmatics are most varied; 
6ome can breathe freely in clear dry air, which drives others 
into a damp cellar for temporary relief : a close, warm room 
which suits one will be unbearable to another. Individuals 
who are never free from asthma in some situations, lose their 
attack as soon as they are removed. 

These are peculiarities of which all should be aware. Ceiv 
tain odors produce asthmatic breathing in the predisposed ;— 



268 Scalds and Burns. 

the powder of ipecac is notorious for this effect ; and the smel 
of new-made hay, so pleasant to most persons, produces hay 
asthma in a few unfortunate individuals. 

Sponging the chest and shoulders every morning with cold 
salt water, friction being afterwards made with a rough towel 
or flesh brush, is a practice to be recommended, provided no 
other predisposition forbids. 

A few drops of aether, put into a, gill of cold tar-water, and 
Inhaled by means of one of the Inhalers recommended in ca- 
tarrh in the head, will be of service in some cases. 

SCALDS AN D BUKNS. 

The frequency of accidents of this kind makes it obligatory 
for every individual to be posted as to the best treatment in 
such cases, as it is necessary to apply our remedies at once, to 
be the most successful, for in all accidents from scalds and 
burns, it seems to be of the utmost importance to apply a 
remedy at the instant ; for by this means the violent anguish 
is allayed, and blistering, which in scalds, at least, is usually 
bo considerable as to lay the foundation for a tedious curative 
process, is in a great degree prevented. 

In the case of slight burns and of scalds, generally the best 
application is the cotton wadding in sheets ; it should be used 
to envelop the injured parts, double if possible, and bound or 
bandaged on with moderate firmness. If this mode of treat- 
ment be resorted to within the first twenty minutes after the 
injury, nothing more need be done ; the cotton may be 
allowed to remain on from twenty-four hours to three or four 
days, according to the severity of the accident. Under its use 
blistering rarely occurs, and if it has commenced before the 
application, it subsides quickly and painlessly. For the first 
ten minutes after the cotton-dressing is put on, the pain of the 
injured parts seems increased, but ere long it diminishes, and 
the inflamed skin appears to relieve itself by gentle perspira- 
tion. In the cases such as above named, when cotton is to bo 
procured — and no house in the country ought to be without 
one or two sheets of it — it is perfectly unnecessary to use any 
•tlier measures. 

A lotion made with six tablespoonfnls of vinegar to a pint 
of water may with advantage be kept constantly applied to a 
burn, if it he not extensive — a saturated solution of carbonate 
of soda has likewise been recommended. Cold water if 
perhaps the most directly grateful application to a burnt 
or scalded surface, and if continued sufficiently long, w^ll 
undoubtedly restore the usual condition of the part, but it 



Scalds and Bums. 269 

mtiBt be persevered with for many hours ; and when a burn or 
scald is extensive, this is a serious objection, in consequence 
of the extreme constitutional depression which so often follows 
the accident, especially in the young. We would warn pa- 
rents of the necessity of watching closely the effects of even 
slight injuries of this kind upon children, particularly when 
the chest or abdomen are the seat of the accident : extreme 
depression — requiring the use of stimulants — may unexpect 
eily come on. and death, from an apparently very slight cause, 
be the result. When cotton is not readily 'procurable, flour 
spriukfed over the surface is an admirable substitute, even in 
slight burns, but is more useful still in those severe effects ol 
heat in which the parts are deeply destroyed by the action of 
fire ; in these cases, flour applied at once, and repeated again 
and again for days together, whatever slight moisture seems 
oozing through the caked covering it forms — is the most gene- 
rally applicable, pleasant, and safest remedy; a little fresh 
sweet-oil applied to the surface in the first instance will make 
it adhere. Applying a thick coat of white lead paint has been 
found an excellent remedy. It should not be washed off, but 
Buffered to remain on until cast off by nature's own process. 

Whatever application is used in the treatment of a burn, 
should be calculated to exclude the action of the external air / 
it ought to be one, also, which does not require frequent chang- 
ing ; the more extensive the surface involved in the accident, 
the greater care should be taken not to expose it to air, which 
increases pain, and adds to the general depression of the sys- 
tem. This depression must always be carefully watched, and 
combated by the use of ammonia, wine, or spirit, sufficient to 
support without stimulating. When pain is excessive, and is 
irritating the nervous system, a gentle opiate is required ; but 
in some of the severest burns, the sensation, not only in the 
injured part, but generally, is either wholly or partially abo- 
lished, in consequence of the shock to the nervous system 
at large. This is always a bad symptom. In the less severe 
forms of injury from heat, if the cotton, the flour, or cold 
water, have been properly used, little after-treatment is neces- 
sary ; but when a burn has been neglected or badly treated, 
the blisters broken, and when the true skin beneath is inflam- 
ed and secreting matter, a simple tepid bread and water poul- 
tice should, in the first place, be applied for six or eight hours, 
and after it an ointment composed of one tablespoonful of 
white lead paint, rubbed up with same amount of perfectly 
fresh lard. This ointment spread on linen quickly relieves ths 
rery painful condition of the injured surface. One teaspoon 



270 Scalds and Burns. 

ful of powdered sugar of lead will do when the paint can not 
be had, rubbed up with oLe tablespoonful of lard. 

In cases of deep burn, with destruction of the parts, aftei 
the flour has been applied some days, it begins to be pushed 
t)ff by the matter formed underneath : at this time poultice? 
are to be continued until the caked flour is separated, and the 
Burface below exposed, after which the simple dressing with 
tepid water will generally be the best and safest applica- 
tion ; or, in a later stage, if healing is slow, use the lead oint 
ment recommended above. 

During the cure of burns involving contiguous parts, suet 
as the Angers, care must always be taken to keep the surface* 
asunder by the interposed dressings : otherwise they may 
grow together. After extensive burns or scalds, the constitu- 
tion requires attention — the stimulating treatment of the first 
few hours or days must be dropped when feverish symptoms 
come on, and mild and cooling diet, gentle purgatives, and 
cooling drinks, as lemonade, apple tea, toast- water, &c, ad- 
ministered: opium or laudanum, in ordinary doses, being 
given if requisite, to allay pain or nervous irritation. This 
system will again require to be changed for one of stronger 
nourishment — meat soups, meat and wine, or other stimuli, if 
there is continued discharge. The use of stimulating diet, 
however, requires caution, on account of the tendency to in- 
flammation of the lining membrane of the stomach and bowels, 
which exists during convalescence from injury to the skin by 
heat. 

The sores left by burns have some peculiarities. They shoot 
out fungous, or proud flesh, as it is vulgarly called; they are 
difficult to heal : and when they do heal, contract so much as 
often to produce great deformity. 

To arrest the growth of this over-growing flesh, sprinkle the 
part with burnt alum, once or twice a day, or apply lunar 
caustic as often as may be required. 

I will state, in concluding this subject, that during my re- 
sidence in Mississippi, during the years 1849-50, 1 had occasion 
in my practice very often to try the application of lunar caus- 
tic to recent burns and scalds, with the happiest effects — the 
pain ceasing almost immediately, and the parts healing in a 
short time. It was applied with a camel's hair brush or linen 
mop at once, and again in a few days, if healing did m<t seem to 
be going on satisfactorily. Twenty grains of caustic liafeohed 
in an ounce of water, were the proportions used. 



Jiheumatism. 271 

RHEUMATISM. 

This disease is divided into the chronic and the acute ; being 
known by the former appellation when there is no great degree 
of inflammation or fever, but merely pains; and by the latter 
when both fever and inflammation exist. 

It may arise at all times of the year ; but the Sprint and 
Autumn are the seasons in which it is most prevalent. It at- 
tacks persons of all ages, but very young people are more ex- 
enrot from it than adults. Those whose employments subject 
them to exposures to great heat and cold, are particularly 
liable to Rheumatism. 

Obstructed perspiration, occasioned by wearing wet clothes, 
lying in damp linen, sleeping on the ground, or in damp cellars 
or basements, or by being exposed to cool air when the body 
ha? been heated by exercise, or by coming from a crowded 
room into the cool air, the causes which usually produce Rheu- 
matism. Those who are much afflicted with this complaint, 
are very apt to be sensible of the approach of wet weather, by 
wandering pains about them at that period. 

Chronic Rheumatism is attended with pains in the head, 
shouldtrs and other large joints, which at times are confined to 
one particular part, and at others shift from one joint to an- 
other without occasioning any inflammation or fever ; and in 
this manner the complaint continues often for a considerable 
time, and at length goes off, leaving the parts which have been 
affected in a state of debility, and liable to fresh impressions 
on the approach of bad weather. 

Acute Rheumatism usually commences with languor, chilli- 
ness, succeeded by heat, thirst, restlessness, and a quick pulse* 
there is also a sense of weight, coolness of the limbs, and con- 
fined bowels. In the course of a day or two, inflammation, with 
acute pain and swelling, makes its appearance in one or more 
of the larger joints of the body. The pain is frequently tran- 
sitory, and apt to shift from joint to joint, leaving the part pre- 
viously occupied, swollen, red and extremely tender to the touch. 
Hie pulse now becomes full and hard ; the tongue preserves a 
steady whiteness ; the bowels are commonly very costive ; the 
urine high-colored ; and often there is a profuse sweating, un- 
attended by relief. 

Sometimes, however, the pain is the first symptom, and the 
fever follows. When the pain is not very severe, and confined 
to a few parts, the fever is slight ; w r hen it is severe and felt in 
many parts, the fever is more considerable, and it is most so 
when the pains extend over the whole body. Both the pain 
%nd fever generally suffer an increase in the evening, and » 



272 Rheumatism. 

remission towards morning. The pains are nrcch increased on 
the slightest motion requiring the action of the muscles affect 
ed, and are most severe, as well as most apt to shift their place, 
in the night time. The fever abates sooner than the local 
symptoms, and is rarely protracted beyond a fortnight or three 
weeks. The pains, for the most part, are the last symptom 
which leaves the patient. 

When an individual who has either suffered from an attack 
of acute rheumatism, or is hereditarily predisposed to it, or 
indeed when any one, after exposure likely to produce an 
attack, suspects the disease to be impending, the first effort 
should be to excite the free action of the skin. If a warm or 
vapor bath can be procured, it is highly desirable ; if it can- 
not, the best substitute will be a well-warmed bed with hot 
bran bags, or hot bottles, and the free use of warm drinks. 
A mixture composed of half an ounce of spirit of nitre, one 
drachm of paregoric, and fifteen drops of wine of ipecac, in a 
wineglassful of water, may be given every four or five hours. 
To the above draught, ten grains of the bicarbonate of potash 
may be added with advantage. Under the above circum- 
stances, any stimulant sweating may be given with benefit, 
even a little gin, or other spirit, or wine, well diluted with hot 
water; these stimuli being used, of course, only at first, and 
while fever is not yet present. 

When an attack of acute rheumatism is established, if medi- 
cal assistance is not immediately procurable, the patient must 
be kept in bed, moderately warm, the thirst quenched by the 
free use of simple warm drinks, and the diet reduced to a very 
lew scale, any thing like alcoholic stimuli, or animal prepara- 
tions, being strictly forbidden, except in the case of very 
debilitated persons, when animal broths, such as beef-tea, may 
be permitted in moderation. If fever runs high, tartar emetic, 
in from an eighth to a fourth of a grain dose, may be given 
every four, five, or six hours, and with this, from six to ten 
drops of laudanum may be combined, to alleviate the pain. 
Dover's powder, in doses from ten to twenty grains, may be 
given at bed time, and followed by a purgative of castor oil 
next morning. The above measures might with safety be 
adopted, under peculiar circumstances, in the absen ie of medi- 
cal assistance. There are, however, many other modes of 
treatment. That by large doses of nitrate of potash, or salt 
petre, has had its advocates, and may be tried : the mode of 
administration, as laid down by Dr. Basham, is to dissolve 
two ounces of the saltpetre in two quarts of water, and to 
give this quantity in the course of twenty-four hours. Thif 



Rheumatism. 273 

treatment;, which h said to be very successful at times, 
might be available in the absence at least of other remedies ; 
of couise, if symptoms indicative of irritation of the stomach 
or bowels came on, it would require to be abandoned. More 
recently the treatment of acute rheumatism by lemon-juice 
has come into practice, and seems in many cases to answer 
extremely well. This treatment has the advantage of being 
perfectly" safe, and therefore, where the lemon-juice can be 
procured, may, without danger, be pursued in the absence of 
* medical man. One tablespoonful, or half an ounce of lemon- 
juice, is to be given every four hours. The " alkaline treat- 
ment" of acute rheumatism is followed by some fifteen to 
thirty grains cf bicarbonate of potash being given, well diluted 
in water, every four hours. 

As regards the local treatment of the inflamed joints, little 
is to be done in a disease which shifts its site as rapidly as 
acute rheumatism; for even if it can be driven from one joint, 
it must, as long as the poison is in the constitution, show itself 
elsewhere, it may be in the heart. 

When the joints are much swollen and painful, much ease 
may be given by enveloping them in a large quantity of the 
6oft carded cotton — " cotton wool" — over which there is wrap- 
ped completely a piece of oiled silk, or oiled paper. By this 
air-tight covering, the joints are kept in a perfect vapor bath, 
and when it is removed after twelve or twenty-four hours, the 
wool will be found saturated with moisture which is strongly 
acid. 

The causes of acute rheumatism already pointed out will 
suggest to most persons the precautions to be adopted, espe- 
cially when liability to the disease exists. Cold and wet are 
particularly to be guarded against, and, after exposure, the 
preventive measures already laid down adopted. Flannel or 
woolen, worn next the skin, must always be regarded as one 
of the chief preventives ; it should of course be proportioned 
ji thickness to the season and temperature. 

Persons of full habit, liable to rheumatic attacks, should 
avoid malt liquor generally, should take animal food sparing- 
ly, and avoid violent exertions which heat the body. Persons 
of spare or feeble habit, may live better, and indeed require 
to keep up the condition of the body to as good a pitch ai 
possible. 

In chronic rheumatism, instead of heat, there is often a sen- 
iation of cold around the affected parts. The chronic nature 
of this disease must generally place it under proper medical 
control ; the chief efforts of the unprofessional must be to 
♦Jorreot any slight deviations from the general health, to pro- 



274 Rheumatism. 

teet the affected parts especially from cold by means of warw 
clothing, and to use friction, either with simple oil, or by 
means of liniment of camphor, sweet oil, and laudanum, in 
equal parts. Much comfort is not only derived from friction, 
but, if combined with proper exercise of the joint or joints, it 
may do much to prevent permanent deformity. In chronic 
rheumatism, warmth of climate is of much importance, and 
as much should be done toward the attainment of thia sfl 
circumstances will permit. 

Chronic rheumatism, properly so called, is such as above 
described ; but the term rheumatism, or rheumatic pain, is 
also used to a great variety of anomalous pains, and from this 
has arisen considerable confusion. The best marked of these 
is " muscular rheumatism," which affects chiefly the thicl" 
muscles, such as those of the shoulders, arms, neck, loins, &c 
This form of rheumatism often comes on suddenly, after ex- 
posure to a current of cold air — sometimes after cold bathing ; 
its chief characteristic is severe pain, when the affected mus- 
cles are thrown into action. This muscular rheumatism seems 
to be a purely local affection, and is generally removable by 
purely local remedies. Of these, the best is a large hot bran 
or other poultice, or some other means of applying heat and 
moisture, applied over the affected part, for a few hours ; thii 
often at once cures — care of course must be taken to protect 
the part to which the heat has been applied, by a covering of 
flannel. After the hot application is removed, if the heat does 
not entirely cure, and even instead of it at times, a liniment of 
camphor, sweet oil and laudanum, in equal parts, or volatile 
liniment, mixed with laudanum, either alone or combined, 
with one-third of turpentine, may be used to advantage ; two 
or three teaspoonfuls being well rubbed into the part every 
few hours. 

Any notice of rheumatism at the present day must be im- 
perfect, without some allusion to electric and galvanic agen- 
cies, galvanic rings, electric chains, &c. That these applianceg 
are at times of apparent service in cases of chronic rheumatism 
is undoubted, and if such is the case, we are not justified in 
rejecting their aid because we cannot exactly explain the why 
and wherefore of their action. 

The author has found, as a general thing, that the wine of col 
chicum, given in from two to five drop doses, three times a day, 

fradually increasing the dose until sickness at the stomach hat 
een produced, or looseness of the bowels, or both ; and then go- 
ing back again to the small doses, (after a day or two,) and gra- 
dually increasing again if necessary, has been the most reliabU 
remedy in rheumatism. A liniment of whisky, (or alcohol) koro 






Nervous Debility. 275 

sine oil, laudanum, sweet oil and turpentine in equal parts, 
applied as needed, is about the best local application. 

NERVOUS DEBILITY. 

ITS CAUSES AND THE CURE. IT IS PRODUCED BY EXCESSES IN- 
MARRIED LIFE, ETC. 

The most potential cause by which this disease is induced 
is the vicious habit of youth, though it may follow more 
innocent causes in those of mature age. 

It is incomparably the most serious affection by which the 
male portion of the race is assailed, as by the ceaseless losses 
of the generative secretions the general health is not only 
greatly depreciated, but the virile capacity also becomes so 
enfeebled by its ravages, that finally the masculine attribute 
becomes wholly passive or destroyed. 

It superinduces a species of atony, or wasting away of the 
genital organs, which often amounts to a paralyzed condition, 
imparting to them the appearance of imperfect development 
which is often real, as the disease, if present in the early 
years of adolescence, effectually retards and arrests develop- 
ment and stunts capacity. 

It is a fixed physiological fact that there is an intimate 
sympathy between the genital organs and the mind — a fact 
which fully explains the despondency, the gloom and misery, 
the loss of memory, the day dreams, the erratic visions, the 
hypochondria, and other evidences of mental disorder by 
which the sufferers from this disease are distressed. 

In consequence of the deterioration of the mind which the 
disease occasions, development of the mental functions are 
sadly interfered with, capacity of acquirement is lessened, 
progress is arrested, and hence the frequent observation of 
the precocious youth becoming the dull adult. 

The sufferer from the deplorable disease, constantly presents 
the evidences of his affection as the facial expression con- 
stantly conveys to others the fact of its existence ; his skin is 
pale and sallow, the eyes are surrounded by dark circles and 
are quite lustless, the pupils are sluggish and dilated, and the 
countenance has a troubled, haggard and furtive expression. 

His manner also betrays his sufferings and decrepitude, as 
do what he will he cannot conquer his shyness, or retiring 
habit; the ease with which he becomes confused, his aversion 
to society, a want of steadiness and decision in locomotion, 
the deficient power in the lower extremities, and many peculiar 
movements all betray a mind ill at ease. 

It is not an uncommon fact for the mental troubles to be- 



276 Nervous Debility, 

come so grave as to induce the most serious disorders, such as 
delusions, insanity, dementia, and epilepsy. 

A slight knowledge of physiology will teach the reader why 
this affection is so pre-eminently destructive of mental and 
physical vigor, and of the vitality of the procreative organs. 

The general functions are controlled and governed by 
nerves radiating from the sacred plexus — a network of ner- 
vous tissue situated at the posterior wall of the pelvis — 
precisely as taste, sight, hearing, etc., are directed by nerves 
arising in ganglionic centres of the brain. A constant 
and unnatural loss of the generative secretion invariably 
induces atony, or paralysis of the plexus, causing the relaxed 
condition of the generative vesicles and the general unmanly 
condition of the organs. 

The generative fluid is also the most highly vitalized secre- 
tion of the whole body, being rich in phosphorus, and the 
various phosphates which also constitute the principal element 
of the nervous tissue. 

It is, therefore, apparent to everyone, that the involuntary 
expenditure of the secretions as fast as secreted deprives the 
nervous system of its normal and reqnired stock of phosphorus, 
and that this poverty is the cause of the debility and devita- 
lized condition of the nervous system and of the decadence or 
complete destruction of such functions immediately under the 
control of the nervous system as the virile capacity or power 
of generation. 

One of the most sad and deplorable fancies of some of those 
who suffer from this unmanly effection is to regard the invol- 
untary losses as an evidence of high physical power, a relief of 
surcharged and exuberant manhood, and a natural sequel of 
continence. This delusion has been the ruin of many, and no 
one should be guided by such a fallacious thought, should it 
even come in the shape of professional advice. 

Every discharge of the generative secretion, if not occurring 
in the natural orgasm, is unnatural, and the result of a dis- 
eased condition, and is sure to affect the general health and 
the tone of the virile capacity. 

All who give themselves up to this odious and criminal 
habit are not so severely punished, but there are none who 
are not more or less so. The frequency of the pollution, the 
variety of temperament, and several circumstances indepen- 
dent of either, occasion considerable differences. The 
symptoms we have the more frequently witnessed are a total 
derangement of the stomach, which occasions a loss of appetita 
or an irregular loss of food ; in others, acute pains, above aS 



Nervous Debility. 277 

during the time of digestion, or habituil Vomitings, which, 
resist every remedy so long as they continue under their de- 
lusions ; a weakness of the organs of respiration, whence fre- 
quently result hoarseness, weakness of voice and shortness of 
breath, upon making any short violent exertions, and finally, 
total relaxation of the nervous system. 

Let me here be permitted to insert some fragments of letters, 
which united, will form a sufficiently complete picture of the 
physical disorders produced by the imprudent habits of 
youth : — " I plainly feel, " wrote one patient, " that this impru- 
dence has diminished the strength of my faculties, and above 
all, my memory. Age, assisted by reason, has for some time 
cured me of that wretched penchant, but the evil is done. To 
an affection and extroardinary sensitiveness of the nervous 
system, and the accidents it occasions, are added a weakness, 
an uneasiness, and ennui, a distress of mind which seems per- 
tinaciously to adhere to me ; I am worn out by an almost con- 
tinual loss of the generative fluid; my countenance has 
become pale, and almost cadaverous , pimples and blotches 
are breaking out all over my face ; the weakness of my body 
renders all motion a trouble to me ; that of my legs is such 
that I have frequently great difficulty in keeping myself on 
my feet, and I dare not venture to leave my room ; my di- 
gestion is so bad that my food passes through almost unchanged 
three or four hours after taking it ; my chest is loaded with 
plegm, which keeps me in continual pain, and the expectora- 
tion wears me out, 

" This is a brief description of my miseries, which are still 
more aggravated by the mournful certitude I have acquired, 
that each succeeding day will be more painful than the pre- 
vious one." 

" Did not religion restrain me," says another, "I should 
already have put an end to a life so much the more cruel as it 
is my own fault." 

In fact, there is no situation in the world worse than that of 
mental affliction ; pain is no comparison to it, and when joined 
to a crowd of physical evils, it is not astonishing that the suf- 
ferer should wish for death as the greatest blessing, and con- 
sider life (if so wretched an existence can be called life), as a 
real misfortune. 

The following case is more brief and less terrible : — "I had 
the misfortune to contract that habit which too soon ruined my 
temperament and constitution ; my state of late years has been 
truly pitiable, my nerves are extremely weak, my hands are 
always trembling without power, and contiually clammy with 



278 Nervous Debility. 

perspiration ; I am subject to violent spasms of the stomach, 
pains in the head, arms, legs, and in the loins and chest, fre- 
quently accompanied with a cough, which is very harassing ; 
my appetite is voracious, yet J fall away considerably, and 
my face becomes every day more cadavorous, and full of 
pimples and blotches." 

Nothing perhaps weakens the intellect so much as these 
habits, which takes possession of the whole mind and atten- 
tion, and prevent their victims from following their respective 
vocations, rendering them stupid, dull and thoughtful, and 
destroying their vivacity, cheerfulness and health, bringing 
on consumption, weakness, barrenness, and all that dreadful 
train of complaints which make the timid uncertain, full of 
whims, and ridiculous. 

It is the imperative duty of every sufferer from this disease, 
no matter how seldom the unnatural losses occur, to engage the 
services of a competent and experienced physician, so that the 
integrity of the general health and the quality of the masculine 
capacities will be both saved from further decadence, and again 
restored to the normal standard of excellence. 

The excesses of early married life are often the cause of 
Nervous Debility and its train of evils, simply because the 
parties do not know what excesses are, having never been 
taught a little of the common sense for the million which can 
be found all through this book. Unmarried men, also, who 
give way to wholly and unbridled passion, by their associa- 
tion with women of a certain class, almost invariably bring 
about a condition of body and mind but little different from 
those who indulge in the vicious habits of youth. 

Sometimes seminal losses are caused by the presence of 
worms in the rectum, or lower bowel, as well as by internal piles 

These things produce local irritation and excitement, caus- 
ing a dream of a lascivious nature, and the loss of seminal 
fluid during sleep. It will thus be seen that it is not only 
the vicious habits of youth that bring about nervous debility 
and all its train of evils, so that each case must be investi- 
gated by the physician and treated according to its cause. 

For further information see page 454 of this work. Few 
persons are aware of the embarrassment and unrest of mind 
produced by this disease, sometimes in persons in early life 
or prime of young manhood, but oftener in older persons. 






Impotence, 279 

IMP OTENCE. 

This mortifying condition follows nervous debility in most 
of cases, where that disease is allowed full and unchecked 
sway. The disease (Impotence) often follows or is produced 
by other causes ; such as sedentary habits, intense study, 
etc. It implies an incapacity to engage in the marital act, 
and not loss of procreative power, that is termed sterility. 
It is dependent upon atony or weakness of the nerves of the 
sacral plexus, a condition spoken of under the head of ner- 
vous debility, and frequently caused by that affection, though 
it may be brought about by injuries and diseases at the base 
of the brain or spine, and by whatever depletes the nervous 
system of its required stock of phosphorus. 

The virile capacity is the strongest of all the human forces, 
and remains as long as any one, and does not, as erroneously- 
supposed, decay in advance of the other forces. While an 
enfeebled capacity may be perfectly natural in advanced age, 
complete impotence at any time is the result of a morbid 
process and inconsonant with the harmony of the physical 
economy. 

It is a well-established medico-psychological fact that vig- 
orous integrity of the virile powers is absolutely necessary 
for the welfare of both body and mind, and for a well-bal- 
anced moral sense. A loss of manhood signifies more than 
mere virile imbecility, it also invariably denotes a loss of 
physical elasticity, mental acuteness, and moral tone. 

These are indisputable facts and fully realized by all those 
who have sustained more or less loss of coitive power. Im- 
potence is, therefore, one of the most deplorable diseases, 
making the sufferer a miserable being. A man without the 
status and functions of his sex, depreciating his physical 
capacity, and mental activity. 

Whenever the virile capacity evinces the least degree of 
decadence it should excite immediate concern, as the process 
of decay is in all cases a progressive one, as every case of 
partial impotence, sooner or later becomes complete, unless 
arrested by the skill of a physician, 

No one should place confidence in the hope that the recu- 
perative powers of unaided nature will effect a restoration of 
coirive capacity, as dependence upon such means of reinvigora- 
tion always ends in disappointment. The only judicious 
course to pursue when decadence of capacity is first observed 
is to engage the aid of an experienced and skillful physician 
who will interpose the required treatment to arrest the process 
of deterioration, and to imbue the organs with renewed vigor. 



280 Impotence. 

It is very frequently the case with those who have been 
guilty of youthful imprudence that they never attain full 
vigor of manhood, a fact of which they are profoundly ignor- 
ant. It is, therefore, of the utmost importance that such 
persons should consult a competent physician before a mari- 
tal alliance is consummated, so as to be secured against the 
mortifying experience of many matrimonial novitiates. 

Greater diagnostic skill and familiarity with pathology is 
required for investigation into the character of each individ- 
ual case of lost manhood than for any other unnatural condi- 
tion, and no physician, however eminently successful he may 
be in other professional spheres, can give decisive or reliable 
advice, or successfully treat the affection, unless he has made 
this particular disease his life-long study, or possess the skill 
which can only be acquired by the treatment of many thous- 
ands of cases. 

It is, therefore, the plain duty of every one of depreciatea 
manhood to seek counsel only of the physician who makes 
the treatment of this condition a specialty. 

We are justified in giving this advice, by the fact that we 
have seen very many cases where the injudicious treatment 
of inexperienced physicians has very measurably increased 
the virile debility, and in not a few cases an incurable condi- 
tion. 

For this reason we do not feel disposed to give here any 
detailed treatment, as each case requires treatment according 
to age, occupation, causes, physical conditions, etc. A great 
many cases have been much benefited by the use of 
" Magneto-Eledriciiy" and very often will need no other treat- 
ment. A small machine, not very expensive, can be had and 
used once a day or more. A mixture of equal parts of syrup 
of the hypophosphites and Extract of Matico, of which take, 
one teaspoonful after each meal in a wineglass of cold water, 
is a valuable remedy, to be used only as needed. 



Diseases of the Skin. — Abscess. 281 

DISEASES OF THE SKIN. 

Almost every person at some time of life, is afflicted with one 
form or another of skin disease, and each person so afflicted at 
once says, "What do you call it? What is it?" etc. Well, 
so far as the name is concerned, it will not make much difference 
to "unprofessional readers, but the following remarks apply to 
the treatment of nearly all ordinary diseases of the skin, such 
as eruptions, blotches, pimples, etc. 

In all such diseases the bowels should be kept open, free, and 
regular. If necessar}^ occasionally take a purge, and if pos- 
sible get a Turkish bath once a week for a time. Keep the 
skin moist with vaseline, and occasionally cleanse with tar soap 
and water. Avoid eating fat meats, butter, etc. If you can- 
not get a Turkish bath, get a good sweat bath once a week, 
and afterwards clean off the skin with soap and water and 
apply vaseline. 



ABSCESS. 

This may be properly called the collection of pus, or matter 
in a cavity formed in the substance of any soft parts of the 
body. The contained matter, or pus, may be either of a 
healthy or of an unhealthy character ; if the former, it is of 
a yellowish-white color, cream-like in consistence, and pos- 
sesses a faint sickly odor ; in the latter case, it may resemble 
whey, with bits of curdy substances floating in it, or it may 
be bloody and offensive. 

Common abscess. An abscess formed on some external part 
of the body, which has been previously the seat of inflamma- 
tion. Whenever inflammation occurs, the most proper course 
is to endeavor to remove it by an early resort to appropriate 
remedies, before it causes suppuration, (or the formation of 
an abscBSo ;) but if this latter cannot be prevented, we must 
endeavor to accelerate its progress by warm fomentations of 
bitter herbs, such as hops and vinegar, boneset, sage, or hore 
bound, and hot water, &c , and by poultices. These are to be 



282 Abscess. 

made of bread and milk; oat-meal or linseed-meal and water 
or slippery elm ; and to promote the ripeniDg of an abscess 
in the inside of the month, a roasted fig or apple may be used. 
When the tonsils (or almonds of the ear) are tending to sup- 
puration, (or coming to a head), the patient should draw into 
tie mouth the steam of boilfng water, alone, or with a little 
vinegar and hops added to it. In general, those poultices are 
best which retain their heat the longest, and they should be 
frequently changed, to prevent their becoming cold, and thue 
having a contrary effect to what we wish them to have. The 
tendency to suppuration may be known by the inflammation 
continuing long; by the stretching pain becoming less ; by a 
throbbing sensation, and the patient's being aifected with cold 
shiverings. When an abscess forms in a place under our in- 
spection, it is accompanied with swelling, whiteness, or yel- 
lowness of the skin, and a soft feel, as if there were a thickish 
fluid in a bag. When matter is formed, it must be discharg- 
ed, and nature endeavors to accomplish this by causing the 
matter to have a tendency to the nearest outlet : thus an ab- 
scess formed in a fleshy part of the body will point to the 
skin ; one in the lungs will burst in the air-cells ; and one in 
the liver, either into the belly, or externally through the side. 
When the abscess is quite ripe, which is known by the pain 
being lessened, and the matter pointing or coming to a parti- 
cular spot, it is, in general, best to give it vent by opening it 
with a lancet, or other clean cutting instrument; and this, in 
the position or situation which is lowest, on purpose to let the 
abscess empty itself by the weight of the fluid. It is better 
to have a free vent of our own making, than to allow the mat- 
ter to find its way under the skin, to distant and inconvenient 
parts, or to allow the matter to discharge itself by a ragged 
and irregular opening. It is almost always proper to make 
the cut large, as a small one is nearly as painful, and as it is 
liable to close too soon, and thus occasion the necessity of 
repeating the operation. When the abscess is large and deep, 
a small piece of lint should be put between the lips of the 
wound, that it may close from the bottom, and this is to be re- 
newed at each dressing. The poultices are still to be con 
tinued till the thick yellow appearance of the matter changes 
into a thin watery discharge ; after this it is proper to discon- 
tinue them, and to dress with simple cerate, made of wax, 
lard, and sweet oil melted together, in equal parts by weight, 
or any good healing ointment. 

When it is wished, as much as possible, to exclude the ail 
from the inside of an abscess, an opening is made by passing 



Boil. 283 

i brohd catling needle, for the purpose of bringing through th« 
rides of the abscess a skein of silk or cotton. This is desirable, 
particularly in lumbar abscesses, or those collections of matter 
which come from the inside of the belly, and point at the up- 
per part of the thigh ; as air admitted into them is often found 
to be the cause of hectic fever, and consequent generally ill 
healf h. 

The degree of danger which attends an abscess, depends on 
its situation and its consequences. If it is situated in the lungs, 
it may burst into the air cells, and prove fatal by suffocation ; 
or if in the liver, &c, it may be effused within the cavity of the 
peritoneum (or lining membrane of the bowels) and excite in- 
flammation there. Large abscesses are dangerous by the wast- 
ing discharge with which they are accompanied ; and by the 
6low fever and general symptoms which, in certain constitu- 
tions, follow them. 

BOIL. 

A Boil is a small tumor common to every part of the surface 
of the body ; hard, tender to the touch, and coming to a head, 
with a hard core in the centre. It is chiefly found in persons 
of a full habit, and great vigor ; but is sometimes met with al- 
to in debilitated patients, who are evidently suffering from ill 
health. 

When it occurs in strong and vigorous patients, they should 
be put on a low diet, and some cooling opening medicine 
ghould be given, as a dose of salts, or cream of tartar, or sen- 
na-tea with the addition of salts. If the boil be large, and at- 
tended with considerable swelling, pain and fever, small doses 
of ipecac, half grain to one grain, should be given every three 
hours. A common poultice should be applied to the boil till 
it suppurates and breaks, when it may be dressed twice a day 
with any good healing ointment, (see Medicines, their doses, 
uses, and manner of preparation,) till it heals. If the ulcer 
gets into an indolent state, and wants stimulating, in order to 
its healing, we may apply the basilicon ointment. Boils not 
infrequently arise in weakly 1-^oits, and where the constitution 
is evidently in an unhealthy state ; in such cases, the patient 
ihould be put on a nourishing diet; he should take daily exer- 
cise, if possible, in the open air, and use the sponge-bath and 
frictions to the surface every other day. The compound de- 
Option or te\ of sarsaparilla is an excellent medicine, and tnaj 
V take^i tv j*? times a day, in one gill doses. 



284 Gum- Bo 11 — Mammary Abscesi. 

GUM-B OIL. 

Gum- Boils are sometimes limited to the fedbstance of the 
/urns, and sometimes connected with the decay of a tooth, 01 
its socket. In the first variety, it is a disease of only a few 
days' duration, and ceases almost as soon as the boil bursts, or 
is opened ; in the second, it will often continue troublesome 
till the decayed tooth is extracted. 

Gum-boils, when connected with decayed teeth, rarely dis- 
perse without coming to a head, and it is, therefore, generally 
better to encourage this process, by the use of warm fomenta- 
tions, (previously alluded to under head of Abscess,) or poul- 
tices, than to repel it. An early opening of the tumor is of 
importance, as, from the structure of the parts concerned, the 
walls of the abscess are mostly tough and thick, and the con- 
fined matter seldom obtains a natural exit with sufficient free- 
dom. A little mild opening medicine, as salts, cream of tartar, 
or senna-tea, every other day, will be found useful ; and after 
the abscess has burst, or being opened, washing the mouth 
once or twice a day with an astringent lotion, will tend materi- 
ally to make the cure permanent. Twenty grains of sulphate 
of zinc, dissolved in half a pint of rosewater, will be a suitable 
lotion for this purpose, or cold green tea will answer. 

MAMMARY ABSCESS or GATHERED BREAST. 

This is an abscess seated in the female breast, affecting 
chiefly women after confinement, or during the period of suck- 
ling. Previous to the birth of the child, a great quantity of 
blood is sent to the womb to supply materials for the growth 
and nourishment of the child ; but when the child is born, and 
requires food of another sort, the blood then flows in great 
quantity to the breasts, and occasions, in some constitutions, 
feverishness, known by the name of milk-fever ; and, in others, 
severe local pain of the breasts, followed by suppuration, or 
coming to a head. Independent of the milk-fever, inflamma- 
tion and abscess of the breast may arise from checking the 
flow of milk at too early a period ; from exposure to cold, 
fright, mental anxiety ; too great motion of the arm, when the 
breast is large and distended ; blows, and pressure from tighl 
clothes. But the abscess of the breast often occurs, when nc 
obvious cause can be assigned. The pain arising from the in 
flammation of so large and tender a structure is very gieat 
and occasions very severe distress. The breast sometimes put* 
on the appearance of several distinct swellings, has a knotted 
feel, and the pain often extends to the armpit. At first, w« 
must endeavor, if possible, to put a stop to the inflammation 



Lumbar Abscss. 285 

and to prevent its coming to a head. This is to be done by 
giving frequent doses of cooling laxatives, as of salts ; by ap« 
plying cold or tepid fomentations to the breast, and by having 
the milk regularly drawn off. We are also to apply leeches 
in great numbers, and to rub the breast gently with a little 
i*arm sweet oil and turpentine. The diet is to be very spare 
and cooling. 

If we fail in relieving the inflammatory state, our next en- 
deavor is, to bring it to a head, by poultices, and to discharge 
the matter, when ripe, by a large opening. When a suppura- 
ting breast is left to itself to break, it too frequently allows the 
matter to work itself into various winding holes, and to make 
its way out by different openings, occasioning a long and wast- 
ing discharge ; to prevent this, there is no method so sure as 
making a large and free incision, and thus lay open, through 
all their depth, the hollows from which the matter flows. 
When a hardness remains in the breast, after inflammation and 
abscess, it is to be dispersed by frictions with camphorated oil 
and spirits of turpentine ; attention being paid to the avoiding 
of external injury from tight clothing, &c, and the general 
health and state of the bowels are to be attended to. 

LUMBAR ABSCESS. 

This is a very troublesome complaint. It is a collection of 
matter forming at the loins internally, and making its appear- 
ance at the upper part of the thigh. At the commencement 
of the disease, there is some difficulty in walking, and an un- 
easiness is felt about the loins ; but, in general, there are large 
collections of matter formed without much previous pain, and 
without any indication of disease, till it begins to show itself 
by an external swelling. 

It is sometimes connected with disease of the bones of the 
Bpine ; but in many cases there is no such combination. It 
very often occurs in scrofulous constitutions, without any obvi- 
dub cause, and it may proceed from blows on the back and 
.oins, and from exposure to cold and damp, as by lying on 
wet ground. 

Should there be any symptoms to lead us to suspect the com- 
plaint coming on, we are to endeavor to prevent it, by keeping 
the patient at rest, and by the application of leeches or cups to th 
•oins, b~ blisters, and purgative medicines. The great difficul- 
ty in the treatment of this disease is, to determine on the mode 
of opening the abscess, when we have decided that such a 
m«asirc is proper. It is found by very general experience, 
that when these large collections of matter are freely opened, 



286 Carbuncle 

and admission is given to the external air, very terrible conse- 
quences ensue ; and that the patient suffers from slow fever^ 
wasting discharges of matter, and, at length, death is caused. 
A plan which has been adopted with success for opening thes€ 
abscesses, is, to make an oblique opening, large en c ugh to 
discharge the flakes of matter and clots of blood from th« 
cavity, then to cover the wound carefully, and get it to hea} 
as quickly as possible. When the matter collects again, a fresh 
opening is made, and the same method pursued as before, 
When the abscess has been opened, or when it has burst, 
which we must always endeavor to anticipate and prevent, the 
strength of the patient is to be supported by nourishing diet, bj 
a liberal allowance of a tea made from Peruvian bark or one 
grain of Quinine, before each meal ; and, in some cases, the 
use of wine ; at the same time, moderating the slow fever, by 
sponging the body with vinegar and water, and by paying a 
proper attention to the action of the stomach and bowels. 
When possible, a physician should be had to attend to such a 
formidable disease as this. 

CARBUNCLE. 

In this distressing disease, for it is one attended with much 
suffering, the first symptoms are great heat and violent pain in 
some part of the body, on which arises a kind of pimple, at- 
tended with great itching ; below winch a round, but very 
deep-seated, and extremely hard tumor may be felt with the 
fingers. This tumor soon assumes a dark red, or purple colcr 
about the centre, but is considerably paler about the edges, 
A little blister frequently appears on the top, which, as it oc- 
casions an intolerable itching, is often scratched by the patient. 
The blister being thus broken, a brown watery fluid is dischar- 
ged, and a scab makes its appearance. Many such pimples 
are sometimes produced upon one tumor, in consequence of the 
patient's scratching the part. Considerable local pain always 
attends the disease. As the complaint advances, several open- 
ings generally form in the tumor. Through these, there is 
discharged a greenish, bloody, offensive, irritating matter. 
The internal sloughing is often very extensive, even when no 
sign of it can be outwardly discovered. 

With regard to the k cal treatment of a carbuncle, the grand 
thing is to make an early and free incision into the tumor, so 
as to allow the sloughs and matter to escape readily. As much 
of the contents as possible is to be at once pressed out, and then 
the part is to be covered with a poultice. Fomentations will 
also be found to afford considerable relief, both before and 



Sickness from Unhealthy Meats, 287 

after an opening has been made. As the discharge is exceed 
ingly offensive anc 1 irritating, it will be necessary to put on a 
fresh poultice two or three times a day. The use of the 
poultice is to be continued, till all the sloughs have separated, 
and the surface of the cavity appears red, and in a healing 
condition ; when soft lint and a pledget of seme unirritating 
ointment should be applied, together with a tow compress ana 
2 bandage. Basilicon ointment, mixed with a little white 
Mtiiol, or alum finely powdered, will answer. The dreadful 
manner in which the disease is protracted by not making a 
proper opening in due time, can not be too strongly impressed 
upon the mind of every patient, and it may justly be regarded 
as a frequent reason of the fatal termination of numerous cases. 

With respect to the treatment for invigorating the general 
health, we should remember that the disease usually occurs in 
two very opposite states of system — in those of full habit, and 
in those of broken down constitution. In the former, eight or 
ten leeches may with advantage be applied round the base of 
a large incipient carbuncle, and free purging, cooling saline 
medicines, such as Rochelle, or Epsom salts ; and a low diet 
be resorted to. In those of broken down constitution, the 
opposite treatment will be requisite — all unnecessary loss of 
blood must be avoided, and the system must be soothed by 
opiates, and supported by quinine, one grain three times a 
day, or tea of Peruvian bark, a gill before each meal, along 
with strong meat-broths, wine or porter. In such constitutions, 
a carbuncle of any size is a serious, and not unfrequently a 
fatal affection. 

It often happens that a large carbuncle has been preceded 
by two or three smaller ones, or boils, in succession. The 
occurrence of these ought always to be taken as a warning ; 
the man of full habit should reduce his diet, meat and stimuli 
in particular ; take exercise freely, and five or six grains of 
blue pill every second night, for a week, followed by a Seidlita 
powder next morning. A tendency to carbuncle in the deli- 
cate or aged should always be seriously regarded, not only as 
indicative of disorder in the system generally, but from the 
direct danger arising from the disease itself. In such case* 
consult a physician at the earliest moment. 

SICKNESS FROM UNHEALTHY MEATS. 
Tha.t sickness, in various forms, such as boils, abscess, car- 
buncle, typhoid fever, ulcers, sores, sorethroat, diarrhoea, 
inflamation of the bowels, and other affections, are produced 
by the use of diseased or unhealthy meats, there can be no 



288 Piles. 

reasonable doubt. I mention it in this place to put persons on 
their guard against eating meats of this kind. Always b€ 
careful to select meats that are free from the least unpleasant 
odor, or when cooked looks unnatural, or that has any peculiar 
unpleasant taste. A whole family has been prostrated with 
sickness by partaking of a joint, or a piece of meat, or a fish, 
a little tainted or having some unpleasant taste. As it was 
cooked and on the table, rather than throw it away, a dinner 
has been made off it, costing much suffering, and perhaps, 
death. The slightest taint of this kind in meat shows that it 
would be unsafe to eat it. 

PILES. 

There are two kinds of tumors observed in piles, the first 
being an enlargement of the veins, caused by the obstruction 
of the blood, which are in the immediate vicinity of the lower 
bowel. They are of a dark bluish color, soft and elastic to the 
touch, and considerably lessened by pressure ; they occur in 
regular clusters, and extend high up in the bowels ; these 
sometimes inflame, burst, and discharge blood profusely. 

The other variety of tumors consist of a thickened, condensed, 
hard lump, of a pale red or brownish color, situated a small 
distance above the margin of the rectum, or outlet of the 
bowel ; the latter are firm, and more fleshy than the former ; 
these may inflame, ulcerate, or remain entire, and give rise to 
very painful and distressing sensations. 

When Piles are accompanied by a discharge of blood, they 
art, called Bleeding, if not, Blind Piles. 

A common consequence of this affection is a kind of bearing 
down sensation ; there is also heat, and throbbing in the part, 
varying from a moderate degree of these sensations to the 
most excruciating suffering; these are caused by the great 
flow of blood to the parts. Sometime the inner coat of the 
bowels protrude at every evacuation, forming what is called 
Prolapsus, or falling of the bowels ; this is the effect of lon£ 
continued irritation and weakness of that organ. In some 
instances the patient experiences nervous pains, which are 
indescribable, and known only to the sufferer, which commence 
immediately after an evacuation, and continue from thirty 
minutes to several hours ; these sensations are very annoying 
and sometimes very distressing. This disease, when of long 
continuance, is attended by pain and weakness in the back, 
irritation of the kidneys aud bladder, and other organs in the 
vicinity, pain and numbness in the legs and feet, a sense oil 
•Iraitness about the chest, and unnatural fulness of the abdo 



Piles. 289 

men, accompanied with palpitation of the heart, and oppression 
Individuals sometimes experience previous to an attack of 
Piles, symptoms denoting great derangement in the circula- 
tion • there is a sense of weight and pressure in the abdomen, 
with a peculiar feeling of uneasiness in the bowels, costiveness, 
and a sensation of bearing down in the parts, attended with 
pain in the back and loins, nausea, and slight pains in the 
itomach, scanty and high-coiored urine, pale countenance. 
Confused sensations in the head, weariness, and irritable and 
discontented state of mind, and a sense of fulness and oppres- 
lion in the region of the stomach. 

This disease is caused by drastic purgatives, torpidity of the 
Jver, costiveness, sitting on cold stones, on the wet ground, &c. 
Sedentary occupations, and high living, of course render the 
above causes more liable to produce the disease ; some indi- 
viduals afflicted with the Piles, are in the habit of remaining 
at stool, and after the bowels have been evacuated of their con- 
tents, they frequently experience sensations similar to those 
preceding the calls of nature ; they feel as though there was 
something more that should be removed, and with this im- 
pression, great efforts are made to expel the delayed contents 
wf the bowels, but all in vain ; the efforts are ineffectual, and 
are followed with pain and anguish. 

Let the patient remember that these sensations are produced 
by the descent of internal Pile Tumors, while the bowels are 
being evacuated, and that very violent expulsive efforts pro- 
trude them still farther. Use as little effort as possible, and 
you will facilitate the cure, and save yourself much unnecessary 
suffering 

After the bowels have been moved, remain quiet for a short 
time, to allow the parts to resume their natural position. Much 
walking or long standing is very injurious, and should be 
avoided as much as possible. 

In cases of Piles, accompanied by falling down of the lower 
part of the bowel, so as to protrude externally, the following 
treatment should be resorted to ; — Take of white oak bark one 
ounce, boiling water a pint ; boil the bark in the water in a 
tin vessel, and let stand one hour, then strain through muslin. 
When cold, inject about a gill up the bowel morning and night, 
or it may be used as a wash to the protruding part of the 
bowels. Or the following may be used. Take one ounce of 
lard, nutgall finely powdered two drachms, fifteen grains of 
sugar of lead, ten grains of powdered opium, (or four grains of 
mornhins which will answer as well.) Mix all thoroughly 
together; of this put about a teaspoonful or two up th« 



290 Stings of Poisonous Insects. 

bowel with the finger two or three times a day. When tin 
bowel is down, first put it up by pushing it back with th« 
index finger well oiled, before using the ointment. This oint- 
ment, or the wash can be used in all cases that are very painful, 
or even ice applied to Piles when they come down and are 
painful, will be found very soothing ; to be applied constantly 
while the pain lasts. Where ice cannot be had the coldest 
water will be found a good substitute, by applying linen clotha 
dipped in the water, to be removed as often as they become 
warm. The oak-bark wash will be the best to use in cases of 
excessive bleeding from the bowels in the Bleeding Piles, to 
be injected into the bowel every three hours. 

A handful of hops, boiled in a quart of water for half an 
hour, then allowed to cool, and applied as a wash or an injec« 
tion is also a good remedy. 

The most thorough cure of this disease, however, is between 
the attacks, to inject half to one pint of cold water up the 
boweJs night and morning, at same time washing the outei 
parts in cold water. Besides this, keep the bowels open by eating 
freely of stewed fruit, such as dried apples, peaches, figs, raisins, 
&c, and if needed, a Seidlitz powder, or dose of Roehelle salts, 
or Castor oil. In persons who are of a bilious temperament a 
Blue pill at bed time occasionally is of great service, always 
giving the next morning some mild purgative, being careful 
always to avoid Aloes, except a sudden or imprudent sup- 
pression of the hemorrhoidal flux is followed by violent head- 
ache, pain of the chest or abdomen, the premonitory systoma 
of apoplexy, or a discharge of blood from the lungs or sto- 
mach, then the remedies are bleeding from the arm in bad 
eases,' active purgatives, as aloes, soap and gamboge com- 
bined ; purgative injections into the rectum ; warm fomenta- 
tions to the parte, either by poultices, or the patient sitting 
over the steam o:. hot water, also putting their feet into a 
mustard bath, &c. 

STINGS OF POISONOUS INSECTS. 

Oder this head we will include the stings of the bee, wasp, 
hornet, musquito, &c. The poison from all insects of this kind 
may be looked upon as of an acid nature, whicn coming in 
contact with the veins, or blood vessels, causes very painful 
symptoms, even dangerous, sometimes. In some it is trifling, 
in others it is very great, and in a few individuals it extends 
over the entire body, while at the same time there is much 
sick faintness, &c, requiring the administration of hartshorn 
and other stimulants. If the sting has been inflicted about tbi 



Fractures. 291 

throat, the swelling has heen known to prove fatal. The domes- 
tic local applications to stings are very numerous. Oil is fre 
quently applied, and gives relief; but alkaline preparations 
certainly appear to be most serviceable. Soda sometimes is 
employed ; but ammonia or hartshorn (the weaker solution) is 
the best form of alkaline application, and it may be used alone 
or mingled with oil. However, before any remedy is used, 
care should be taken to ascertain that the sting does not remain 
vn the wound. If it does, it must be extracted by tweezers or 
by squeezing. If the pain and swelling remain severe, a 
solution of one teaspoonful of sugar of lead in a pint of water 
and kept constantly applied to the parts affected, by means of 
cloths dipped therein, will be found beneficial. Sometimes 
poultices have been used with advantage in these cases. 

Fit A C TURE S. 

The bones most frequently broken, are those of the extreme- 
ties. It is called a simple fracture, when there is no opening 
from the fracture externally ; but a compound fracture, when 
there is an external communication. In old age, as well as in 
particular diseases of the constitution, bones are more liable to 
oe broken : and also, in winter. This formerly was supposed 
to arise from the influence of cold ,' but it is now believed to 
be the result of extraordinary muscular action, excited by the 
exertions to avoid falling on the frozen and slippery places ^r 
pavements. For this reason, persons whose muscles are re 1 ax- 
ed, as in a state of intoxication, much less frequently have 
their bones broken from a fall, than those who are sober and 
very solicitous to guard against tumbling. 

The symptoms of fractures are, severe sudden pain, altera- 
tion in the form of the part, sometimes a shortening of the 
limh, an inability to move the limb without severe pain at the 
injured part, an inequality of the shin covering the bone : a 
grating, (called crepitation,) of the edges of the bone against 
each other; a motion and noise not to be mistaken for any 
other. By taking hold of the limb above and below the 
fracture, and moving the fractured extremities of the bone, the 
noise is produced, and the existence of the fracture rendered 
unquestionable. It is well here to remark, that the fewer of 
these attempts made, the better; as it is injurious that the 
edges of the bone shoul I be much rubbed over each other. 
When the parts are much swelled before examination, the dif- 
ficulty of ascertaining the fracture is increased. 

The union of fractured bones is effected nearly in the same 
manner as that of the soft parts. The inflamed vessels poui 



292 Fractures. 

out the matter necessary for the union, and the absorbing ves- 
sels take up the unnecessary parts. The matter poured out foi 
the union, is called callus / it is at first soft, but gradually be- 
comes lirm and hard. 

In the treatment of fractures place the parts of the broken 
bone as near as possible in their original position, and keep 
them so until union is effected. The first is done by mode* 
ately extending the parts, so that the edges may be made to 
come in contact ; the other is done by the application of splinti 
and bandages. 

The treatment of the patient, as it relates to the constitution, 
is to be regulated by circumstances. A certain degree of in- 
flammation is essentially necessary for the process of restora- 
tion. If it be too violent, instead of the formation of callus for 
the reunion, common matter will be formed ; it will come oui, 
and, thereby making an opening, will convert a simple into a 
dangerous compound fracture. The inflammation must be 
regulated, not so much hj purges, as generally it is very in- 
convenient ; but chiefly by small doses of ipecac when nece*- 
sary, and low diet ; but when the inflammatory stage is passed, 
the individual should return as much as possible to his ord^ 
nary food. Care must be taken, if the person has been accuj** 
tomed to much alcoholic stimulant, that it is not unduly 
abstracted, otherwise the powers of the constitution will be so 
reduced that the reparative process cannot take place, and the 
fracture will remain ununited. 

When the soft parts are much injured, greater attention is 
necessary to keep down the inflammation, than when only the 
bone is broken. In cases where there is much swelling, or 
much effusion of blood, applications of sugar of lead and water, 
one teaspoonful to the pint, and local bleeding by leeches, can 
alone prevent the formation of matter. In every case where 
it is proper for the patient to remain in bed, it is necessary to 
have a bed pan for the evacuation of his bowels : if a good one 
cannot be had, a better mode will be to have the patient lay- 
ing on a mattress, with a hole in it of a proper size ; the mat- 
tress should be on a plank bottom, and a door, in which another 
hole is to be, correspondent to that in the mattress ; in these 
holes are to be suitable stoppers. And when the patient wish- 
es to evacuate, the door and all are to be elevated, the stopper? 
removed, and a pot placed underneath to receive the discharge, 
which being finished, the whole is to be replaced. In some 
places, bedsteads with screws and pullies, are made to effect 
these objects : but as they cannot be had in the country, a 
contrivance can be made to answer in the way I have suggest 



fracture of the Lower Jaw. 293 

ed, requiring no skill in construction, and the labor of only 
one or two to place and replace it. Under any circumstances, 
it is improper to place the patient oa & feather bed, on account 
of the irregularities necessarily ensuing. If a hair or straw 
mattress cannot be procured, it is better to substitute a few 
folded blankets or quilts on even boards. 

After a fracture has once been set, it should never, if pos- 
sible, be disturbed again. This does not mean that the appli 
ances are not to be removed, and the progress of the case 
inspected ; for if this be not done, and if by any chance the 
proper position should have been disturbed, the bones may 
become solidly fixed in an improper manner, and deformity 
result, or the skin may become ulcerated. But the appliances 
should not be removed, if possible, before the end of the first 
week, and if all seems going on well, not moved again for ten 
days at least, unless for some special purpose. If a fracture in 
often disturbed or pulled about during the process of consoli- 
dation, it may chance that this will only be effected imperfect- 
ly, and what is called a false joint formed ; that is, the broken 
part, instead of being firm, moves like a joint, and the limb is 
useless. It had better be crooked or shortened. 

Much care is always required that a limb which has been 
fractured is not used too soon after the accident ; otherwise it 
may be either snapped again, or it may be bent. 

FRAC TTJRE OF THE LOWER JAW. 

This bone is liable to fracture in all its parts. The symp- 
toms are, severe pain at the time of the accident ; an inequali- 
ty is perceived in passing the fingers along the bottom of the 
jaw; the teeth, on examination, are found unequal; and on 
taking the two sides in the hands, it is easy to reduce the teeth 
to their proper level, and in doing so, the grating motion is 
perceived. 

To reduce the fracture, nothing more is necessary than to 
•hut the mouth, and forcibly push upwards the lower fragment, 
ttntil the teeth contained in it come in contact with those of 
the upper jaw, when it is to be supposed the parts are in pro 
per place. The simplest and best plan to keep the parts in 
place, is to avail yourself of the support given by the teeth in 
the upper jaw, by binding the fragments firmly against them 
and this can be very conveniently done by means of a simpl 
roller of common cotton muslin passed repeatedly round th 
top of the head and under the chin. It may be further secured 
by passing a few turns of it round the back of the neck and in 
front of tne chin. 



294 Fracture of the Bibs. 

The patient should be nourished fifteen or twenty days on 
spoon victuals, sucked between the teeth ; and the only addi- 
tional remark we have to make, is that when the teeth at the 
fractured bone are loose, they are not to be touched ; much less 
removed, as that would convert the simple into a compound 
fracture, or, in other words, admit the air to the broken parti 
of the bone. 

The following treatment is recommended by some surgeons, 
as being the most simple : — Two narrow wedges of cork, about 
an inch and a half long, a quarter thick at the base, and sloping 
to a point, are placed between the teeth, one on each side ; a 
piece of pasteboard softened in warm water, or of gutta-percha, 
is then to be moulded round the jaw, and fixed, either by a 
bandage or handkerchief going over the crown of the head. 
By this method, space is left between the front teeth for the 
administration of liquid nourishment. The sufferer should 
rinse the mouth frequently with tincture of myrrh and water. 

FRACTURE OF THE RIBS. 

These are generally broken near the middle. The fracture 
is ascertained by a severe pain felt at the injured spot in every 
motion of the body, even in breathing : by careful examina- 
tion with the hand ; and by feeling the grating of the bones, 
particularly when the patient coughs. This grating sensation 
may be felt by another person laying the hand on the injured 
parts. The only treatment necessary, is to pass a roller about 
six inches wide repeatedly around the chest, and as tight ae 
the patient can suffer it to be drawn. It is to be prevented 
from falling down by shoulder straps. 

When the edges of the bone have wounded the lungs, some 
times there is spitting of blood; and violent, if not fatal, 
inflammation may follow. On this account, an individual who 
has suffered from fractured ribs should be especially careful, 
and for some little time after the accident should reduce his 
usual diet considerably. The application of the hot bag of 
bran for some days after the accident will afford much relief 
*md it may be used over the usual bandage. When ribs on 
both sides of the chest are injured, this, with leeches if requi- 
site, should be the sole application ; the patient being confined 
to bed for at least a fortnight or three weeks, in the posture 
found to be the easiest, which will probably be a half-sitting 
one, supported by pillows, or some other means. When the 
ribs on one side only are injured, less confinement is required. 
Dut the chest should be encircled, as firmly as can be borne 
comfortably, with a band of stout calico, from eight to ten 



Fractv/ni of the Arm, and of the Forearm, 295 

inches wide, and double ; this should go once and a half round, 
and be sewed. A month will probably be required for the 
cure 

FRACTURE OF THE ARM. 

This most generally occurs about half way between the 
shoulder and elbow. When it is broken directly across, and 
near the middle of the bone, no great derangement takes place ; 
the limb preserves its length, and its form too, unless it be 
moved. The mode of treating this fracture, is to set the patient 
on a chair ; one person is to hold the body, with his arm around 
the chest ; another the foream (between the wrist and elbow) 
bent at right angles over the breast, and to raise it a little 
from the side, and extend it, when the operator is to place the 
two ends of the bone in contact; to pass around the arm, from 
the elbow to the shoulder, a roller, moderately to compress 
the part without impeding the circulation. He then applies a 
splint of wood, firm paste-board, or of raw hide, on the top of 
the arm, from the elbow to the shoulder ; then another on the 
outside, of similar length ; and in the inner side of the arm 
another, from the armpit to the lower part of the elbow. 
These are to be secured by another roller or bandage. Folds 
of flannel are to be placed in the armpit, to give some support, 
And the forearm is to be suspended in a sling. At the expira- 
tion of a week, the parts are to be examined, and, if found 
out of place, to be rectified ; the joint at the elbow should be 
gently and carefully moved, in order to prevent stiffness ; and 
this ought to be repeated, after the first week, once every 
other day. At the end of three weeks, it is recommended to 
alter the dressing and substitute splints, which instead of keep- 
ing the arm bent at right angles, will keep it nearly extended. 
This is done to prevent its partial deformity. 

FRACTURES OF THE FOREARM. 

Tbe forearm (extending from the wrist to the elbow), is com- 
posed of two bones ; and sometimes only one of them ii 
broken, at others both. The symptoms are, great pain at the 
time of the accident, increased by motion of the hand ; an 
inability to turn the hand either up or down, and the grating 
common to all moveable fractures. 

To reduce the fracture, the forearm is bent to a right angle 
with the arm ; an assistant takes a firm hold of the arm j ust 
tobove the elbow ; a roller is to be applied, extending from the 
tiand to a little above the elbow ; two splints, broader than 
the arm, made of either of the materials before mentioned, 
are to be applied, one on the inner and the other on the outei 



296 Fractures of the Thigh. 

side of the hand, extending from the fingers up to the elbow, 
leaving the thumb upwards, projecting between them. The 
hollow places should be filled up with tow or cotton, and a 
bandage applied around, to preserve the whole in place. 

In about ten days the parts are to be examined, to see that 
all is going on right. In thirty or forty days, the union is 
generally completed. The elbow and wrist should be moved 
every other day, as in fractures of the arm, after the first week* 
When only one of the bones is broken, the treatment should be 
ffce same. 

When the bone at the elbow is fractured, it is drawn up by 
the muscles attached to it, leaving a considerable space be- 
tween the broken parts. The proper treatment of this acci- 
dent is to extend or straighten the arm, and apply a broad 
bandage around the arm, one beginnin£ at the fingers and 
extending up to the elbow joint, and the other beginning at 
the shoulder and extending down to the elbow joint, to com- 
press the muscles, and thereby prevent their action in separa- 
ting the broken part. The separated bone is to be pushed 
down to its natural place, and a long compress placed on it, 
over which is to be applied a roller extending the greater way 
over the arm and forearm, (as explained before) ; a large long 
6plint is to be put on, extending from the inner part of the 
arm to the hand, and a roller is to be applied from beginning 
to end, commencing at the hand. It should be so passed 
around the elbow as to form a kind of figure of 8, in order that 
the upper part of the bone may be kept down by its oblique 
compression. In about thirty days, the joint may be very 
gently moved by the hand of an assistant — but it is not to be 
attempted by the patient for nearly double that time, as the 
parts otherwise might be ruptured again. 

In fractures of the bones of the hand and fingers, all that 
is requisite is to restore the parts as accurately as practicable 
to their natural position, and preserve them in as quiet a state 
as possible ; taking care, as in all other cases, to prevent the 
inflammation faom extending too far. 

FBACTUHES OF THE THIGH. 

There can be no doubt, but that in all such cases when sur 
gical aid can, it will be obtained. But in case of this being 
imposs.ble, it may be of service to add, that the patient is to 
be laid on a mattrass on boards, with a hole in it for the eva- 
cuation of his bowels. — That instead of the splints, usually 
lecomm ended on such occasions, it may suffice to have a box 
made without a top, just wide enough to receive the limb, and 






Fractures of the Knee Pan. 297 

+/ i&igth to extend six or nine inches beyond the foot, up to 
or dear the crotch, with the outer plank, or side of the box, 
to extend by itself up to or near the armpit. In this part 
there is to be a couple of holes, for tieing a bandage securely 
The limb is to be placed in the box, with a pocket handker- 
chief so equally applied to the foot, that it shall not bind too 
much on any one part. Another pocket handkerchief is to 
be applied between the thighs; one end to go under tho 
erotch, up to the hole in the outside plank of the box ; the 
other end is to go up in front to the other hole, and the two 
ends are to be tied together. The next operation, is to puL 
the limb downwards, and put the bones in place : and the 
handkerchief around the foot is to be extended and secured 
to the end of the box by any contrivance that will hold it. 
Thus the handkerchief between the thighs will preserve the 
extension above, and that at the foot will extend the lower 
limb, and it may occasionally be drawn tighter. 

This rude sketch, will enable you to do some good on such 
occasions. The box ought not only to be made of firm ma' > 
rials, but should be well lined or stuffed in every part where 
it touches the flesh of the patient, with finely carded and 
•moothly placed cotton or tow, to prevent excoriations. 

FRACTURES OF THE KNEE PAN. 

When this accident occurs, the patient generally falls ; 
though sometimes he gets up and by dragging the limb side- 
ways, may be able to walk, taking great care not to bend the 
knee. A depression or hollow at the place or fracture is per- 
ceived, and commonly the upper is found considerubly drawn 
up from the inferior part, which is fastened to the lower 
hone. 

The great object to be attended to in the treatment of these 
fractures, is to preserve the fragments as near as possible toge- 
ther, so that the substance connecting them may be as short 
as possible, and the motions of the joint be perfectly preserved. 
— In proportion to the violence producing the fracture, should 
be the attention to keep down inflammation. 

The local treatment consists in keeping the limb at rest, in 
in extended posture : and by a splint and bandages preserv- 
ing the contact of the fragments. This is done by taking a 
piece of plank about half an inch thick and three inches wide, 
and extending from the upper end of the thigh to the heel. 
Upon this splint, covered with folds of cotton or flannel so as 
to fill up the inequalities of the limb, the patient's leg and thigh 
are to be placed. A common roller is to be carefully applied 



298 Fractwre of the Leg. 

from the foot to the knee, and one from the top of the thigh down 
to the knee, so as to equally compress all parts, leaving none 
exposed ; but you are to observe, in passing the roller over the 
knee, as in the case of the elbow, it is to be so done as to 
press down the upper to the lower part, making, as in the 
other case, the figure 8 ; so that the roller as frequently passes 
one part below, the other above the fragment several times, 
when it is to be continued to the thigh. A compress of folds 
of flannel, should previously be put over the knee. 

The limb is then to be equally bandaged to the splint under* 
neath. Some surgeons recommend too slips or bands of 
doubled muslin, each a yard long, to be nailed underneath 
the splint, at a distance of six inches from each other, and 
about the middle of the splint, or just so as to be anderneath 
the knee. These bands are to be passed — the lowur one above 
the upper fragment, and the upper one below, — so as still to 
make the figure 8, and press down the upper to the lower part. 
The joint should gently be moved by an assistant about the 
thirtieth day, to be continued moderately every other day, 
to prevent stiffness. 

FB AC TUBES OF THE LEG. 

In fractures where the bone is broke directly across, it ia 
merely necessary to reduce the fracture with the hand, when 
the limb is extended, and apply a roller from the foot to the 
knee ; then two splints, one to each side, of pasteboard or 
thin plank, extending from the knee to the sole of the foot ; 
and over these splints another roller is to be applied, to pre- 
serve them in their places. The bandages should never be 
drawn too tight, as the limb will swell, and they may do in- 
jury by compression. The limb is now to be placed on a 
pillow, and put in a box, or, what will answer, between two 
long slips of plank, which are to be tied around, so as to sup- 
port the whole. 

When the fracture, instead of being directly across, is in an 
oblique direction, it is necessary to dress the limb in the same 
way as in fractures of the thigh bone ; excepting that, when 
the fracture is not near the knee, the upper part of the box 
may be fastened a little below or around the knee ; and there- 
fore its external side need extend no farther. There should 
be a hole in the upper part of both the inner and outer side 
of the box, and the handkerchief or band should be so made 
as to pass from the knee through each ot these holes, where 
k h to be fastened. Another handkerchief is then to be ap- 
plied around the foot, which is to be extended ; then the endi 



Fracture of the Collar Bone. 299 

of the handkerchief fastened to the end of the box, so as tc 
piaserve the extension of the limb. Of course, a roller is first 
applied around the leg from the foot to the knee ; and the box 
is to be well supplied with cotton or tow, to fill up the ine- 
qualities of the limb 

FKACTUKE OF THE COLLAR BONE. 

When it is broke, the part nearest the shoulder is drawn 
downwards by the weight of the arm ; the arm of the affected 
ride fails over upon the breast, and the patient is unable to 
raise his hand upon his head. He leans to the fractured side ; 
the grating ot the bones may be perceived ; and the finger 
passing over the bone, will readily detect the place of frac- 
ture. 

This fracture has frequently been successfully treated, by 
simply keeping the patient laying down, with his arm so placed 
that the broken edges of the bone may be in contact. But 
most commonly it is dressed in the following manner : — A 
bolster or pad is to be made of quilted cloths, in the shape of 
a wedge, about as long as the arm, four inches wide, and at 
least three inches thick. This is to be put under the arm, the 
base close to the armpit, the point down the side ; and it is 
here to be well secured by a roller passing around the body, 
and so turned over the shoulder that it cannot be displaced : 
a contrivance which any one can make, who will exercise com- 
mon sense. The patient being seated on a stool, and held by 
an assistant, the operator is to bend the elbow at right angles, 
and the forearm is to be supported by a sling around the neck, 
the arm and elbow are to be pressed to the side ; the wedge 
above acts as a point for the extension of the broken bone, 
and it is to be bound down in that state by a wide roller passing 
around the body and over the elbow. It is impossible to give 
an accurate description of the particular manner of applying 
the bandages. By tne exertion of sound sense, it can be done 
to effect the main objects, which are, first, to preserve in place 
vhe wedge underneath the arm ; second, support the arm bent 
on the breast ; and third, to press down and keep the elbow 
on the side, so that it shall cause the extension of the uppei 
part of the arm, and consequently the broken bone. A slip 
i)f adhesive plaster will be sufficient to cover the broken 
bona. 



800 Dislocations, or Out oj Joint. 

DISLOCATIONS, or OUT OF JOINT. 

The necessity for the speedy reduction of a dislocation is 
great, from the fact that every day increases the difficulty oi 
its performance ; and when a certain time has elapsed, no forc« 
which can be exerted — consistent with safety to life and limb 
— will be adequate to return the displaced bone, partly ow ; ng 
to the resistance of the muscles, but also to obliteration ot 
doing away with the cavity which formed the one portion o' 
the joint. When dislocation occurs, two different actions take 
place ; one, that by which the bone is driven from its usual 
position ; the other, the action of the muscles, which tend gtili 
further to draw it from its proper site as soon as the balance ol 
resistance of bone against bone is removed. It is, too, in most 
cases, the action of the muscles which tends to keep the bono 
displaced, and to resist the efforts made to replace it. This is 
evident from the fact, that if a person be seen immediate!} 
after a dislocation, and while suffering from the faintness which 
almost invariably accompanies the accident, and while the 
muscles are necessarily in a state of weakness and relaxation ; 
the dislocation may often be reduced with the greatest 
possible ease, even by the unskilled ; and further, when 
the surgeon has to deal with a case of dislocation in a 
strong and muscular subject, he endeavors to produce this 
faintness — if that following the accident has passed away — by 
bleeding, nauseating medicines, warm baths, &c. ; chloroform 
and aether inhaled are used by surgeons and physicians, but are 
not safe in inexperienced hands. 

When, therefore, a dislocation occurs, the bone is not 
simply pushed out of its place, but is drawn for the 
most part upward, or toward the body ; the dislocated bone of 
the finger is drawn upward over its fellow ; the arm-bone, in 
dislocation of the shoulder, may be drawn upward, or into the 
arm-pit — in this case downward, it is true, as regards the joint, 
but still toward the body ; and the same will be found to be 
the case in most forms oi dislocation. The first object, there- 
fore, in treating a dislocation, must be to draw it down from 
or out of the situation to and in which it has been drawn and 
is retained by the muscles of the limb, and to get it as neai 
the corresponding part of the joint, or, in other words, as neai 
the part from which it has been dislocated, as possible. If thf 
dislocated bone is thus drawn down to, or near to the level oi 
the other portion of the joint from whicn it has been re- 
moved, the muscles will of themselves tend to draw it into its 
old position. A good deal is often said about the adjustment, 
&c, <fcc, of the bone in reducing dislocations ; and though, 



Dislocations, or Out of Joint. 301 

pei haps, useful in some cases, in many nothing of the kind it 
required, at least unprofessional persons should not attempt it 
all ftiat is to be done is, give the muscles the chance of draw- 
ing the bone into its old place, by bringing it to a position in 
which this can be effected. This is often exemplified in cases 
in which much force is used in the reduction of a dislocation ; 
[f the force be kept up strongly, the bone cannot be drawn in- 
to its socket, because the force is stronger than the muscles of 
the patient ; but relax the external force for a moment, and 
without any fitting or adjustment, the bone is instantly drawn 
into its proper position by the power of its own muscles. There 
is yet another important principle involved in the reduction of 
dislocations. It has been pointed out how the bone farthest 
from the body — which is usually drawn up — is to be drawn 
down ; but, that this may be done properly, the bone above it 
must be fixed, otherwise it will be drawn down too. This is 
easily effected in such cases as the ancle or the wrist, by any 
one grasping and holding firmly either the leg or the forearm ; 
but in the case of the hip or the shoulder, more management is 
requisite. 

Again, in " making the extension," that is, using the forcible 
effort to return the dislocated bone to its place, the extending 
force will best be made in the direction in which the limb is 
fixed, and in the manner most likely to bring the joint portion, 
or " articulation " of the displaced bone, as near to the old 
position as possible, and it must be applied directly to the bone 
which is displaced. Thus, in dislocation of the shoulder, the 
reducing force is applied to the arm-bone ; in dislocation of 
the hip to that of the thigh. This extending power may sim 
ply be by the hand, but a cloth, or band of some kind, put 
round the member to be replaced, is often more advantageous. 
The particular dislocations most likely to be recognized and to 
be remedied by unprofessional persons, are those of the small 
joints, such as fingers and toes ; of the wrist and ancle ; of the 
elbow, shoulder, and lower jaw. 

Dislocations of the fingers or toes may generally be made 
out by any person, and should, if possible, be reduced at once ; 
the dislocated bone being grasped, and forcibly pulled into 
place ; or a noose, made with a piece of tape, may be used. Dis- 
vocatior of the thumb, it should be known, is extremely diffi- 
cult of reduction, and should this not be effected at once, the 
attempt ought to be given up until the surgeon's arrival; 
it 16, moreover, one of the dislocations which may be left unre- 
duced with less subsequent inconvenience than many others. 
Dislocation of the ancle is very generally accompanied with 



302 Dislocodions, or Out of Joint, 

fracture, but the distortion rs often so great and evident, and 
the suffering so severe, that when the accident does occur fa? 
from proper aid, some attempt ought to be made to put the 
displaced parts into better position. For this purpose, while 
one individual grasps the leg firmly, another, putting cno hand 
on the heel and the other on the instep, should endeavor, while 
steadily pulling downward, to bring the joint into its naturai 
position. 

Dislocation of the "Wrist is produced by the forearm being 
tightly grasped by one individual, the surgeon laying hold ol 
the patient's hand in his, and endeavoring by steady pulling 
downward, and slight up and down movement, to bring the 
joint into its proper condition. 

Dislocation of the Elbow, if attended to quickly after the 
accident, may often be easily reduced by seating the person in 
a chair, carrying the arm well behind the back, and pulling, 
not very forcibly, upon the forearm. 

Both these dislocations — of the wrist and elbow — may be 
suspected, when, after violence — particularly such as is calcu- 
lated to push either the hand or lower arm upward — inability 
to use the limb below the seat of the injury, and distortion and 
impaired motion of the joint, are unaccompanied with any 
grating sensation, such as occurs when a bone is fractured. 

Dislocation of the Shoulder is generally occasioned by 
violence applied to the elbow, or by falls, while the arm is not 
close down to the side of the body. Sometimes the exact dis- 
crimination of an injury to the shoulder joint is a matter of 
much difficulty, for fracture alone or fractures with dislocation 
may occur. At other times, particularly in thin persons, it ia 
tolerably easy made out — more so if the examination is made be- 
fore swelling comes on. In addition to the general symptoms of 
dislocation already enumerated, the injured shoulder will be 
perceptibly altered in shape ; it will appear more depressed 
and flatter than the sound one, and if the hand is placed upon 
the spot which ought to be occupied by the round head of the arm 
bone — and this may be discovered by examination of the unin- 
jured shoulder — it will be found hollow ; and further, if the arm 
be now gently moved about, and its bone traced up toward the 
shoulder, it will be found moving in some unusual position, 
most probably in the arm-pit. Supposing, therefore, that th« 
case is sufficiently clear, the means for the reduction ought to 
be set about as speedily as possible — if it can be, while faint- 
ness from the injuries continues. One method of reducing dis- 
location of the arm-bone into the arm-pit frequently employed ia 
for both patient and surgeon to lie down upon the ground sid« 



Dislocation of the Lower Jem. 303 

by side, bat with their heads different ways, and so that the 
surgeon having previously taken off his boot, can place hii 
heel in the arm-pit of the patient, while he grasps the hand, or 
a towel fixed jto the arm of the effected side ; in this way, while 
fiie heel is used to push against the displaced bone in the arm 
pit it, combined with the pulling exerted by the surgeon upon 
the limb of the patient, tends to give a leverage by which the 
bone is so placed that it can be drawn into the socket by the 
■roscles. This method may be a convenient one, when only 
one person is in company with the individual to whom 
the accident has happened. The following is the most useful 
and most generally resorted to method of reducing a dislocation 
of the shoulder. The patient being seated on a chair, a large 
towel or a table cloth, folded broad, is to be passed round the 
chest, close under the arm-pit of the affected side, crossed over 
the opposite shoulder, and held either by a strong assistant or 
fastened to some fixed point. By this application, the shoulder 
blade is fixed ; the arm itself is then to be pulled, chiefly in the 
direction in which it has been fixed, firmly, steadily, and slow- 
ly / this being done, either directly by the hands of assistants, 
or by a towel fastened round the arm by the hitchnoose. If 
when this steady pull has been persevered in for some time, 
the displaced bone does not get into place, the effect of sud- 
denly taking off the attention of the patient may be tried, 
either by some sudden exclamation, or by dashing a little cold 
water in the face. By such a proceeding, the muscles which 
resist the reducing or pulling force applied to the arm, are for 
a moment, so to speak, thrown off their guard, and that moment 
may suffice to permit the bone to pass into its socket. 

DISLOCATION OF THE LOWER JAW. 

Tms accident, in most cases, is produced by yawning, 01 
opening the mouth excessively wide. It is sometimes produced 
by a blow upon the chin while the mouth is opened. The 
syirptoms of its occurrence are, an inability to close the mouth; 
immediately before the ears an empty hollow space is per- 
ceived ; the cheeks and temples are flattened ; the spittle flowa 
from the mouth ; speech and swallowing are difficult, and the 
chin projects forward. When the jaw continues dislocated 
fceveral days, these symptoms are not so strongly marked, though 
they are still in greater or lesser degree. 

To effect the reduction, the patient is to be seated on a low 
chair, his head supported against the head of an assistant ; th« 
operator is to defend his thumbs with a piece of leather or linen 
be is then to place them as far bank on the jaw teeth as he can ' 



304 Dislocation of the Collar Bone — Contusion*. 

the fingers are then placed under the chin ; and while he pressei 
down the back teeth with his thumbs, he at the same time 
raises up the chin with his fingers ; and then the chin is pushed 
backwards, when the parts become replaced very suddenly. 
As this is done, the operator is as quickly to move his fingerg 
from under the teeth to the cheek. After the operation, the 
patient should for some days live on soup, &c, in order that 
the jaw may be at rest to recover its strength. 

DISLOCATION OF THE COLLAR BONE. 

This accident is generally occasioned by falling on the shoul- 
der, and is ascertained by examining with the fingers ; the end 
of the bone being found under the skin covering the elevated 
point of the shoulder bone, there causing considerable projec- 
tion. The patient inclines his head to the affected side, and 
moves the arm and shoulder as little as possible. The treat- 
ment of this accident is precisely the same with that oi 
fracture of the collar bone. 

CONTUSIONS or BRUISES. 

The bad consequences of bruises are not invariably propor- 
tioned to the force which has operated ; much depends on the 
nature and situation of the part. When a contusion takes 
place over a bone which is thinly covered with soft parts, the 
latter always suffer very severely, in consequence of being 
pressed at the time of the accident, between two hard bodies, 
feruises of the shin thus frequently cause death of the soft 
parts, and troublesome sores. Contusions affecting the large 
joints are always serious cases ; the inflammation occasioned 
is generally obstinate, and abscesses and other diseases which 
may follow, are consequences sufficient to excite serious alarm. 

In the treatment of bruises, the practitioner has three indi- 
cations, which ought successively to claim his attention in tho 
progress of such cases. 

Tlie first is to prevent and diminish the inflammation, 
which, from the violence done, must be expected to arise. To 
effect this, the bruised parts should be kept perfectly at rest, 
and covered with linen, constantly wet with cold water, or 
sugar of lead and water, one teaspoonful to the pint. Wher 
the muscles are bruised, these are to be kept in a relaxed poei« 
tion, and at rest, until the effects of the bruise are entirely 
removed. 

If the bruise has been very violent, it will be proper to 
apply leeches, and this repeatedly. In every instance, the 
bowels should be kept well open with saline purgatives, seid 



Sprains. 305 

litz powders, Rochelle and Epsom salts, etc., and the patient 
put upon a low diet. 

A second object in the cure of bruises, is to promote the 
absorption of the extravasated or bruised blood by liniments, 
etc. These may at once be employed in all ordinary contu- 
iions, not attended with too much violence ; for then nothing 
is so beneficial as maintaining a continual evaporation from 
the bruised part, by means of cold applications, and at th« 
§ame time, repeatedly applying leeches. In common bruises, 
however, a solution of salammoniac in water, or vinegar ana 
water, is an excellent application ; but most surgeons are in the 
habit of ordering slightly stimulating liniments for all ordinary 
contusions, and certainly they do much good in accelerating the 
absorption of the bruised blood. The soap and camphorated 
liniments are as good as any that can be employed. 

In many cases, unattended with any threatening appear- 
ances of inflammation, but in which there is a good deal of 
bruised blood and fluid, bandages act very beneficially, by the 
remarkable power they have of exciting the action of the 
.ymphatics (absorbents) by means of the pressure which they 
produce. 

A third object in the treatment in contusions, is to restore 
the parts to their proper tone. Rubbing the parts with lini- 
ments has a good effect in this way. But, notwithstanding 
such applications, it is often observed that bruised parts con- 
tinue for a long while weak ; and swell, when the patient 
takes exercise, or allows them to hang down. Pouring cold 
water two or three times a day, on a part thus circumstanced, 
is the very best measure which can be adopted. A bandage 
should also be worn, if the situation of the part will permit. 
These measures, together with perseverance in the use of lini- 
ments, and in exercise, giadually increased, will soon bring 
everything into its natural sfcate again. 

SPRA INS. 

Injuries of this kind generally affect the wrists, ankles, and 
knees, being produced by sudden or violent exertions, slipping, 
or falling, etc. They are followed by violent pain immediately, 
and then swelling and inflammation. There is generally a 
rupture of the blood vessels within, and consequently an effu 
iion of blood. The skin is not discolored for some hours 
after which it generally becomes of a dark bluish or red color 
.ncreasing or disappearing, from the inflammatory state, in 



proportion to the extent of injury 
The best remedy for lessening the effects of a sprain, is that 



306 Wounm. 

nearest at hand — cold water. As soon as the accident hap 
pens, the part should be plunged in cold water, or a fe* 
pitchers of cold water poured over it. The next remedy 
is w$X, perfect rest: the part being kept rather elevated, never 
hanging down. The cold applications stop the effusion of blood, 
and promote its absorption : the elevation of the part retards 
the passage of blood to it. It is customary to apply brown 
paper, (rags are as good), wet with vinegar, or spirits, and 
water to the part, ana continue them wet on the part for sov- 
eral days. Sugar of lead and water, a teaspoonful to the pint 
is also a good application. Spirits of comphor, or opodeldoc. 
may with advantage be rubbed over the part, and it should 
gently be daily rubbed with the hand or a ball of cotton. 

Should inflammation come on, you must purge freely, live 
on low diet, and continue the cool applications of sugar of lead 
and water, etc. Leeches on the spot most inflamed, will do great 
good, and so will cupping near it. If the part be much dis- 
tended and painful, poultices at night of flaxseed, or elm bark, 
will aid in removing it. But if you will have patience in the 
first instance to confine yourself and follow the first directions, 
you will probably never have need of other advice. But from 
very trivial accidents of this nature, the neglect of necessary 
precaution has been followed by a loss of the joint, by stiff- 
ness, by decay of the bone, and loss of the limb in conse- 
quence. 

If pains or numbness remain after the sprained part is 
otherwise relieved, the pouring of water on it from an elevated 
spout, and frequently rubbing it with camphorated spirits, 
two or three times a day or more, will be the proper remedies. 

WO UNDS. 

In cases of wounds, even of a trifling nature, comparatively, 
there is generally much excitement. This should be over* 
come by the exercise of good judgment and common sense. 
Then, the first circumstance, generally, which calls for atten 
tion as the consequence of a wound is the effusion of blood, 
but none of the consequences, perhaps, exhibit greater varia* 
tion. Sometimes an extensive injury may by inflicted, evea 
the arm torn off at the shoulder, and yet the loss of blood be 
extremely small ; on the other hand, a puncture with a pen- 
knife, if it penetrates an artery, may be sufficient to place life 
in the greatest immediate jeopardy. As a general rule, prob» 
ably, putting the opening of large vessels out of the question 8 
greater amount of blood is lost after simple cuts than after any 
other description of wound. When laceration or bruising 



Wounds. 307 

takes place, there is usually, by stretching, or otherwise, of the 
coats of the arteries, a sufficient amount of mechanical imped- 
iment caused to modify greatly, if not wholly to prevent, any 
hemorrhage. When a wound is small, the best method of 
treatment is to tie it up at once with a*piece of linen rag ; this 
Is usually sufficient at once to stop the bleeding, particularly 
if rest and position are attended to ; the small quantity of 
blood which may exude, quickly dries upon the wound, and 
forms a kind of glue which effectually excludes the air. As 
no better dressing can be used, it may be left on till the cut is 
well ; in some cases, before using the linen, it may be advisa- 
ble to draw the edges of even a small cut together, by means 
of adhesive plaster, or material of some kind. Although linen 
is mentioned in the above directions, of course, should it not 
be at hand, soft calico may be used, or other soft material. 

When a wound is extensive and the bleeding yrofuse, it 
will not do to bind it up in this way ; first, because it proba- 
bly would not be sufficient to arrest die flow, and if it did so 
ultimately, it would retain a large amount of clotted blood, 
either in or about the wound, in such a way as to interfere 
with the healing process. In a large wound, therefore, it is 
necessary that the bleeding should be almost entirely arrested 
before it is dressed, that is, closed up, &c. 

It should be borne in mind that the first end in view when a 
wound is dressed, is to get as much of it as possible to heal by 
the "first intention," or by " adhesive inflammation;" that is, 
to get the several parts to adhere at once, without formation 
of matter, and thus with as little pain and trouble as may be. 
When the wound is a simple cut, this desirable termination 
may be expected, and often realized. To attain the end, how- 
ever, in many wounds, considerable care is requisite. In the 
first place, the wound must not be closed so soon as that a clot 
of blood will form between the exposed surfaces ; if it does, un- 
less extremely thin, it will prevent union. In the second place, 
when the wound is closed, its surfaces must be placed in as 
accurate a position as possible, and must be thus kept together 
till the process is complete. To effect and maintain this con- 
tact, various agencies are employed, and of these, position is 
not the least important, that is, the placing of the parts so that 
the surfaces of the wound may, as far as possible, fall into con- 
tact, and that, when other dressings are applied, there may be 
no dragging to get things to meet. Thus, in a wound of the 
forepart of the neck, it is requisite to fasten the head so as to 
privent its being thrown back. At the same time, position 
must be regulated with a view to prevent hemorrhage. The 



308 Wounds. 

wounded parts being properly placed, the next object id to 
draw the surfaces into as close a position as possible ; in some 
cases, this is sufficiently well done by means of strips of ad- 
hesive plaster, placed at such intervals as will permit discharge 
of matter, should any form. Frequently, however, from the 
nature, site, or extent of the wound, plaster is not sufficient 
to keep the edges together, or to counteract the natural tea 
dency of the skin to retract when severed. In such instances, 
ititches are employed. These consist of a piece of a sufficient- 
ly stout silk or linen thread passed through the thickness of 
the skin, at about the distance of a line from each of the sev 
ered edges. The thread is passed by means of a curved surgi- 
cal needle, if it can be had, and the two ends being tied, bring 
the edges together, and retain them most effectually in contact ; 
that is, provided the stitch is not made use of to drag parts in- 
to place ; this it should never do. If there is a continued 
strain upon the stitches, not only do they cause much pain, but 
they quickly cause ulceration, which, by detaching, renders 
them perfectly useless. The surfaces of a wound having been 
brought into contact, a piece of thin linen, soaked in water, 
should be placed over it, and if possible, a lightly applied 
bandage. This not only keeps the dressing in place, and 
assists to exclude air, but gives support, which is always ser- 
viceable, and often, in large wounds, absolutely necessary. The 
bandage may be kept wet with cold or tepid water, as most 
agreeable to the feelings of the patient. When a wound pro- 
gresses well toward recovery, when there is no appearance of 
discharge, or so little that it is neither inconvenient nor offeit 
sive, there should be no meddling ; the less the processes of 
reparation are disturbed the better, and in some cases a week 
may be allowed to elapse before the dressings are disturbed ; 
they may of course require it before, especially in warm 
weather. It ought to be remembered, that in the treatment 
of all wounds, it is important to exclude the action of the air 
as far as possible ; and, that rest, simplicity, and cleanliness, 
are the great promoters of healing ; the last being best attain- 
ed by the use of water alone. No balsams or similar applica- 
tions should be employed ; and, except it be a little perfectly 
sweet fresh lard occasionally, ointments may be entirely dis 
pensed with. 

The above observations have been directed specially to 
simple incised wounds; when laceration or contusion accom 
panies the injury, the principle must be to get the wound a* 
much into the condition of a simple incision as possible. To 
do this — the wound having been thoroughly cleansed from 



Wounds of the Joints. 309 

dirt, grit, &c, by means of a soft sponge and water, and any 
foreign body which can be easily reached, removed — all parts 
not absolutely detached from the body are to be placed at 
nearly as possible in the natural position, stitches and plastera 
being used to retain them, and free exit left for the discharge 
of matter ; over these there must be applied either poultice, or 
cloths dipped in cold water, and a bandage may be necessary 
©r not, according to circumstances, which those in attendarce 
must direct to the best of their judgment. 

Punctured Wounds. — As a general rule, these require no 
other treatment than the extraction of any foreign substance 
which may be left in them, when it can be easily done ; and 
to lessen the chance of inflammation, by keeping a warm 
poultice on them, to preserve the surface relaxed, and facili- 
tate the discharge of any matter which may be formed at the 
bottom of the puncture. When inflammation is threatened, 
the means to prevent and lessen it have been pointed out under 
head of Bruises, &c, and should be pursued. 

These wounds sometimes end in convulsions of the muscles, 
and are most apt to be followed by lockjaw. Sometimes it 
is found necessary to dilate the wound and fully divide any 
nerve or tendon which may have been punctured ; sometimes 
a blister over the part has succeeded without the division. 

WOUNDS OF THE JOINTS. 

In all cases of wounded joints, it is important to place the 
limb in such a posture as to favor the union of the sides of the 
wound, in order to prevent the admission of air, which seldom 
fails to produce general irritation. Not only absolute rest is 
to be enjoined, but a very low diet, with slight laxatives. The 
parts should always, when practicable, be brought together, 
and kept so by slips of adhesive plaster, in preference to sewing 
them up : and when they are to be stitched, the needle should 
only pass through the shin, and never to enter the cavity of 
ihe joint, where they would increase the inflammation. Treat- 
ed in this way, they very generally speedily unite without 
inflammation. 

In order more effectually to procure absolute rest of the 
joints, it is necessary to apply splints to fit the parts, which 
being lined with soft materials, occasion no inconvenience. la 
wounds of the knee, ankle or elbow, these splints are indis- 
pensably necessary. When there is reason to apprehend a 
stiff joint, it is necessary to choose the position of the limb in 
which the stiffness will be least inconvenient to the patient, 
And to preserve that posture during the cure. If, for example^ 



310 Whitlow or Felon. 

the elbow were to heal with the arm permanently extended, 
the limb would be almost useless ; whereas, an arm bent at 
the elbow, may be useful. — And the reverse in the knee, as 
an extended leg would favor walking. 

WHITLOW OR FELON. 

This is a disease with which very many persons are pain 
fully acquainted. It is a painful and distressing inflammation, 
seated at the end of a finger or thumb, generally terminating 
in the formation of matter. The inflammation appears in dif- 
ferent parts, either at the root or side of the nail, or near the 
end of the finger, or underneath the whole of the soft parts : 
or underneath the immediate covering of the bone, and the 
bone itself. The most distressing kind is that where the ten- 
dons are affected, and the inflammation extends along the hand, 
up the arm — sometimes rendering amputation necessary. 

In the treatment of this affection, we should act with an en- 
ergy proportionate to the degree of disease. In all cases of 
fever, blood-letting by leeches, from the part, purges and low 
diet, should be enjoined. In common cases, repeatedly scald- 
ing the finger by suddenly dipping it in boiling water, proves 
sufficient. It is much better to use the strongest lye, than 
water for this purpose. Coating the entire part with caustic, 
(nitrate of silver) will also sometimes check the disease. A 
blister plaster should be applied around the whole finger, ia 
order to excite action on the surface, to relieve that under- 
neath ; and it ought to be kept continually discharging. When 
matter is formed under the nail, it should be scraped away 
over it, and a small puncture made for letting it out. When- 
ever there is reason to believe that matter is formed in any 
part, by all means, freely cut down to it, and give vent to it. 
Immediate relief from pain will be had, and an end be put to 
the danger of prolonged, distressing, and dangerous inflamma- 
tion : for the subsidence of the inflammation and healing o? 
the part are very rapid ; whereas, when the parts burst, as in. 
jominon boils, these operations are very tedious and painful. 
Of course, after opening a felon in this manner, poultice* 
fhould be frequently applied until the healing is nearly com. 
pleted, then fiasilicon ointment is more proper, or gome heal 
tng ointment twice a day. 



Cancer. 311 

CANCER. 

This disease is not treated of here with the expectation that 
the nnprofe§fck nal will at any time attempt the cure of tliia 
most dreadful malady, but to point out its symptoms, that it 
may be guarded against in time, and also to offer such sug- 
gestions for the alleviation of the sufferings of the patient as 
may be employed when a physician can not be had to attend 
to it. 

Cancer is of two kinds, the scirrhous, or hard, and the open 
or ulcerated ; but these may be more properly regarded aa 
different stages of the same disease. By occult or scirrhous 
cancer, is meant a hard tumor, for the most part accompanied 
by sharp darting pains, which recur more or less frequently. 
This tumor, in the course of time, breaks and ulcerates ; and 
then is more strictly denominated cancer. The parts of the 
body subject to cancer are the following: the female breast 
and the womb ; the lips, especially the lower one, the tongue, 
the skin, the tonsils, the lower opening of the stomach, and 
some other parts, chiefly glandular. Chimney-sweepers are 
subject to a cancerous affection of the scrotum. 

In general, cancer begins at a small spot, and extends from 
thence in all directions. Its progress is more or less quick in 
different instances. In general, it is too true, that scirrhus is 
Beidorn or never dispersed, and that it causes, finally, the neigh- 
boring parts, whatever their nature may be, to put on the 
eame diseased action ; and thus the skin, the muscle, &c, are 
all involved in the same destructive process. In consequence 
of this morbid action, the skin above a cancerous tumor be- 
comes attached to it, and the tumor is also attached to the 
muscles below. The tendency to this unhealthy action begins 
in the neighboring parts, even before it can be distinctly seen. 
As the swelling increases, it becomes knotty and unequal on 
its surface, and this inequality has been considered as charac- 
teristic of the disease ; almost in every case a darting pain 
is experiencee. The hard swelling which is likely to termin- 
ate in cancer, is attended generally by the following assemblage 
of symptoms : the skin is puckered, and of a dull, livid, color, 
the part is knotted and uneven, occasional darting pains shoot 
through it ; it is attached to the skin above, or to the muscles 
beneath ; and in some cases there is a peculiar unhealthy look 
about the patient. The skin generally may become the seat 
of cancer. Of the internal organs, the womb in the female, 
%nd the stomach, are the most frequent seats of the disease. 
Cancer is very rare under thirty years of age. When, from 
the nature of a tumor, its hardness, situation, age of the 
patient, and particularly if there be any hereditary bias to 



312 Cancer. 

ward the disease, incipient cancer is suspected, there should 
be no trilling, no leechings, or rubbing, or fomentings ; the 
advice of a skilful surgeon should be sought at once ; and 
neither time, distance, n^r expense, should stand m the way 
of procuring that assistance which may not only preserve life, 
but save from a lingering and painful death. 

Should the suspicion be unfounded, the mind is restored to 
peace ; should they be correct, the one remedy, excision, or 
eutting out, cannot be too soon submitted to, before the glandi 
adjacent to the disease, or other textures of the body, oecom.4 
tainted. In any stage of the disease, however, the advice ol 
the regular practitioner ought to be taken. Above all, let the 
twfferer and the friends beware of being tempted by the adver- 
tisements of quack remedies, and of wasting time of which 
every day is precious. Those who advertise to cure cancer, 
you can always set down as impostors ; it cannot be done — only 
by cutting out. Many swellings and sores called cancer have 
been healed by simple remedies, these are the great cures per- 
formed by cancer doctors, and cancer remedies. 

If cancer has reached the stage at which hope of cure must 
be given up ; when it has become an open, grey-looking ulcer, 
discharging thin, offensive matter, the seat of shooting and 
gtinging pain, and when the constitution is affected, it only 
remains to make the situation of the sufferer as comfortable as 
possible. Opium in its various forms is the great soother, and 
the other anodynes, hemlock, especially, both internally and 
as a poultice, are all of service. Codliver-oil in some cases 
allays the pain and retards the progress of the disease ; but the 
regulation and administration of these remedies must be com- 
mitted to the care of the medical attendant ; the domestic 
remedies must be the most perfect cleanliness and kindest con- 
sideration for the comfort and irritabilities of any one who is 
the victim of cancerous disease. Cancer cannot be said to 
be propagated by contact ; but this should be avoided as 
much as possible — in the intimate relations of husband and 
wife especially, whatever the organ or structure affected. 

The lower lip is not unfrequently the site of cancer in old 
people, especially, it is said, in those who smoke much. A pain- 
ful sore in this situation, which will not heal ought not to be 
neglected, but submitted to medical examination. If there was no 
other reason why the use of Tobacco should be avoided than 
this one danger arising from smoking, this should be enough. 
Beware of tne poisonous weed which costs millions of money 
every year, and destroys so many valuable lives without being 
of any possible advantage to compensate for ^ts destructive 
property. 



Deafness^ and Diseases of the Ear. 313 

DEAFNESS, AND DISEASES OF THE EAR. 

laE external ear may be lost by violence, as by cutting 
dff or the bite of an animal, etc. If we see it soon after an 
accident, and find it much lacerated (torn), we are to at- 
tempt its reunion by adhesive plasters, and even by stitches, if 
necessary. When a bandage is applied it should be only 
moderately light, as pressure in this place gives considerable 
uneasiness. Wounds, and loss of a part, or even the whole 
<3f the external ear, do not always occasion deafness. If this 
occurs from such a cause, an ear-trumpet or similar con- 
trivance must be used. Foreign bodies, as peas, bits of glass, 
or cherry-stones, may get into the ear, and occasion great pain 
of the part, as well as impaired hearing. Such bodies have 
been known to occasion for many years excruciating pain of 
the head, palsy, convulsions, and other distressing symptoms, 
all which have speedily ceased when a skilful hand has ex- 
tracted the offending body. Such bodies should be forced out 
if possible, by the injection of warm water and the applica- 
tion of a small scoop or bent probe. Worms have been 
known to produce very violent symptoms, by being hatched 
in the ear. When there is disease, as ulceration or suppura- 
tion in the ear, insects are attracted by it, and deposit their 
eggs, which in time produce worms. Patients so affected 
ghould take care to stop the ear when they go to sleep, in 
Rummer and autumn. A slight infusion of tobacco in oil of 
almonds may be dropped into the ear ; and this proves fatal 
to worms. 

A very frequent cause of deafness or impaired hearing, ia 
the obstruction of the passage by thickened or hardened wax. 
The symptoms arising from this cause are deafness, a sensation 
as of a noise or clash wnen eating , or of heavy sounds, as of a 
hammer. This kind of deafness is not very difficult of cure. 
A little olive oil, or oil of almonds is to be dropped into the 
ear, and retained there by a piece of cotton ; and when the 
wax is softened, it is to be taken out with a small scooped 
instrument. Injecting warm water with a little soap, by a 
•yringe, is a method of getting rid of the hardened wax, 
equally simple and efficacious. A deficiency of the wax may 
occasion a degiee of deafness. When this is the case we are 
to drop in two drops every night of the following mixture 
6weet oil, spirits of turpentine, sulphuric ether, of each, equal 
parts. Shake well before using. The bowels must be kept 

fently open. When the wax is of bad quality, which if 
nown by its deviation from the healthy color and consistence, 
it may be improved by frequently washing the passage; and 



314 Deafness, and Diseases of the Ear. 

giving once or twice a day, a wine-glassful of the infusion 01 
tea, of quassia with a teaspoonful of equal parts of rhubarb 
and magnesia. Discharges of matter take place from the 
passage in consequence of inflammation going on to suppura- 
tion, from scrofulous ulcers, from abscesses after fevers, from 
Bmall-pox, measles, and other causes. These discharges not 
unfrequently are attended with the loss of the small bones; 
•nd in general, total deafness is the consequence. Exposure 
to cold frequently produces inflammation about the ear, at> 
tended with very acute pain, (commonly termed ear-ache), 
which continues very troublesome, and even alarming, till the 
patient is relieved by the discharge of matter. This infiam 
matory state is to be treated by local bleeding (leeched and 
cupping), the injection of tepid water, and by fomentations 
of hops, or hoarhound and vinegar, and the passage should be 
protected from cold air by the introduction of wool 02 cotton* 
Sometimes there is disease in the drum of the ear, attended 
with offensive, thick discharge, which makes its appearance 
at the internal opening, shows that the membrane of che drum 
is destroyed ; and so much disease is in the internal parts, that 
the small bones are discharged externally. In time, a con- 
tinual discharge from the ear takes place, and tho disorgan- 
ization is so complete, that a total loss of hearing is the con- 
sequence. If this disease be noticed in its early stage, if there 
is acute pain, followed by a discharge of matter, we know it 
is from inflammation, and we are to palliate or remove this by 
topical bleedings (leeches and cupping), purgatives, and small 
doses of ipecac every three hours ; and are on no account to 
inject stimulating spirituous fluids. When the disease threat- 
ens to be more chronic, we are to use blisters and setons, as 
auxiliaries to our cure ; to employ laxative medicines, and to 
foment the part as before noticed ; and when there is little 
active inflammation, to throw in a stringent injection as of sul- 
phate ot zinc, a teaspoonful to half a pint of water. If there 
are fungous growths (proud flesh), they are to be touched with 
caustic. 

Sometimes there is deafness from insensibility of the nerves 
of hearing, though the structure of the parts may be perfect. 
If we can ascertain this to be the case, we are advised to put 
the patient on low diet, and to give saline purgatives, seidlits 
powders, salts, etc., once or twice a week, applyir^g blisterc 
occasionally behind the ears. The application of electricity 
may oe tried. 



Mortification. 315 

MOBTIFl CATION. 

The following symptoms will indicate that mortification haa 
taken place. When any part of the body loses all motion, 
sensibility and natural heat, and becomes of a brown, livid, 
or black color, it is said to be affected with sphacelus, that 
is, complete death or mortification. As long as any sensibi- 
lity, motion, and warmth continue, the state of the disorder 
*f termed gangrene or mortification. 

In inflammations of the external parts which terminate in 
mortification, the process observed is as follows : the pain 
eeases, the purulent, thick matter, becomes acrid (irritating) 
and sanious, (watery), bubbles of air are set at liberty, collect- 
ing in small blisters under the skin, or distending the whole 
organ by swelling. The blood is coagulated (clotted) in the 
vessels of the gangrened part, and the circulation can not be 
restored. In many cases, a slight delirium comes on, followed 
either by dejection of spirits or calmness of mind ; but in each 
case attended with a peculiarly wild expression of counte- 
nance ; though sometimes with a very peculiar expression of 
serenity, and a blackness under the eyes. The pulse is usually 
quick, low, and often intermitting. In the earliest stages, 
deep incisions are attended with a discharge of blood, still 
florid (or red), but the skin, the muscles, etc., soon melt down 
into a brownish offensive mass. We conclude that similar 
processes take place in the internal parts when they become 
mortified. When this occurs in strangulated hernia, (rupture) 
or in inflammation of the bowels, a remission of the violent pain 
takes place, and the patient and his friends are deluded with 
the hope of complete relief; but the experienced physician 
knows the treacherous symptom, and must not deceive them 
with false hopes. There is a peculiar kind of mortification 
called dry gangrene, in which the disease begins in one of the 
toes, particularly in old people, and very often after a person 
has been paring a com or toe-nail. It sometimes stops spon- 
taneously, and deprives the patient of some of his toes, or even 
of his foot and leg, as cleanly as if it had been amputated by 
a surgical operation : at other times it has been successfully 
treated by giving large doses of opium- In this form of mor- 
tification, the parts affected are perfectly dry, hard, and not 
liable to run into putrefaction. 

Mortification is brought about by general or local causes. 
Those which affect the general system, are the violent infiam- 
matorj fevers, or the jail and hospital fever ; as also scnrvy 
and dropsy, long-continued or intense cold, and some internal 
changes, which we can not trace nor explain. The local cause* 



316 Mortification. 

©f mortification are numerous. Some of them are burns, ex 

cessive cold, the application of caustics, the strangulation oi 
a part, as in hernia, severe bruises, as gun-shot wounds, bad 
fractures, violent inflammation, pressure on large blood-vessels, 
by tumors, &c. Long continuance in one posture, as when a 
person is confined to bed, gives occasion to gangi'ene of the 
parts where the bones have the least flesh upon them, and which 
are therefore much exposed to pressure ; as thcshoulder blades 
the haunch-bones, ana the lower part of the spine. Hospital 
gangrene is produced by some indescribable state of the air 
in hospitals, jails, and ships. During its prevalence, the small- 
est scratch or ulcer is apt to turn to a fatal gangrene. In 
dropsy, occurring in a broken-down and debilitated constitu- 
tion, if a few punctures be made to let out the effused fluid, or 
a Mister be applied, these are apt to run into gangrene ; it is 
also not unusual for spontaneous blisters to form and break on 
such dropsical limbs, and to go on to mortification. 

"When inflammation is so violent and strong as to give reason 
to fear that it will end in mortification, it is a call for us to use 
with great dilligence, purging, low diet, cold applications, and 
the other means for abating it, taking care that we do not 
continue them too long, lest we add to the debility and exhaus- 
tion which are to follow. 

When the mortification has fairly begun, our remedies must 
be very different from those which counteract inflammation. 
We are now to prevent debility by giving a nourishing diet 
and tonics. Of the class of tonics, the most efficacious is the 
Peruvian bark ; and in a great variety of cases, the good effects 
of the Peruvian bark are very remarkable. Taken in the form 
of tea, (cold), a gill three times a day ; or one tablespoonful of 
the tincture. When the weakness is very great, the use of quinine, 
two grains three or four times a day, or wine may occasionally 
be required, as also ammonia and other stimulants. We must 
be careful not to give these remedies when there is much strength 
of pulse and inflammatory symptoms remaining. When our 
remedies are successful, and the mortification is about to cease, 
a separation takes place at the verge of the sound part, caused 
by a slight degree of inflammation. 

Some have advised cold lotions near the verge of the morti* 
fied part, to check the further progress of inflammation ; bu 
fomentations and poultices are commonly preferred. To the 
common poultices, in some cases, are added powdered charcoal 
or yeast, to correct the offensive odor and to counteract putre 
faction Stale beer grounds, or port wine, with linseed meal, 
make a good poultice. It is necessary to give vent to putrid 






Foreign Bodies in the Outlet or Throat 317 

matter, and for this purpose pretty deep incisions are required 
through the dead parts. 

After the mortified parts have completely separated, and a 
healthy running ulcer is left, the latter is to be treated by 
common poultices, until healing commences, when the use of 
•trips of adhesive plaster applied over the surface of the ulcer, 
and proper bandages, will, in general, cause it speedly to heal 
©ver. Washing the parts with castile soap and tepid water, 
& also advisable. 

FOREIGN BODIES IN THE GULLET or THROAT. 

It is not at all an uncommon occurrence for foreign bodies 
to stick in the gullet, as pieces of crust, or meat not completely 
chewed, or small bones, beans, stones, pins, or pieces of money. 
Borne of these would produce a very bad effect if not quickly 
removed from the gullet ; and perhaps still worse, if pushed 
down into the stomach ; but sometimes pretty large bodies 
have passed downwards into the stomach, and have been dis- 
charged by stool in a few days, without any inconvenience. 

Pins and other sharp bodies, when they have stuck in the 
throat, have been returned by swallowing a piece of tough 
meat tied to a strong thread, and then pulling it up again. If 
the detained body can be with safety pushed down, the pro- 
bang, a flexible piece of whalebone, with a piece of sponge se- 
cured to its end, is the proper instrument. If the bodies can 
not be easily moved up or down, endeavors should not be con- 
tinued long, lest inflammation come on. When endeavors 
fail, the patient must be treated as if laboring under an inflam- 
matory disease, and the same treatment will be required if an 
inflammation takes place in the part, after the obstructing body 
is removed. A proper degree of agitation has sometimes suc- 
ceeded in removing the body sticking in the gullet, better than 
instruments. Thus, a blow on the back has often forced up a 
substance thac has stuck in the gullet, or passed into the wind- 
pipe. Pins which have stuck in the gullet have been dis- 
charged by ridinor on a horse or in a carriage. Above all 
things, in 3ases oF this kind, try to " keep cool" as the saying 
is, for in the excitement more harm may be done than good. 
A knowledge of the nature of the substance in the throat should 
direct you in extracting it ; always being careful in the use 01 
any Hung in the shape of a hook, that the throat may be not in* 

Iured ; the patent must he firmly held, to avoid accidents from 
lis sudden movements. 



318 Grwvel. 

GRAVEL, or STONE IK THE BLADDER. 

In this disease it must be observed that the urinary sand 01 
gravel deposited on the sides or bottom of a receiving vessel 
is of two kinds, red and white/ and it is of great importance 
to distinguish the one from the other, as they proceed from 
different causes, and require a different mode of treatment. 
The symptoms of red gravel are well known. The shade of 
color may vary from a reddish brown, or pink, to a perfect red 
In such cases the urinary secretion is generally small in quar* 
tity, and high colored, and the disease inflammatory : the 
nearer the deposit approaches to a perfect red, the more severe in 
general are the symptoms. 

White gravel is less common, but has long been observed to 
be attended by very distressing symptoms. These consist in 
great irritability of the system, and derangement of the 
digestive organs generally. There is often a sallow, haggard 
expression of countenance ; and as the disease proceeds, symp- 
toms somewhat analogous to those of diabetes, (or great flow 
of urine), begin to appear, such as great languor and depression 
of spirits, coldness of the legs, and other symptoms of extreme 
debility. The urine is invariably pale, and voided in greater 
quantity than usual ; and after standing, for a greater or less 
time, always deposits a most copious precipitate of a white fine 
powder. In all such cases, the urine is extremely prone to 
decomposition, and emits a most disgusting odor. 

The chief cause seems to be a want of constitutional vigor, 
and especially in the digestive organs ; the periods of life in 
which this disease occurs most frequently, are from infancy to 
the age of puberty, and in declining years : while it is rarely 
met with during the busy and restless term of the prime of 
life, these complaints being seldom met with in warm climates. 
The drinking of hard water often influences very sensibly the 
state of the complaint. White gravel may often be very dis- 
tinctly traced to an injury of the back. 

In a healthy state the urine is always an acid secretion, and 
it is the excess of its acid that holds the earthly salts it con- 
tains in solution. If, from any cause, it be deprived of this ex- 
cess, or, in other words, the secretion of its acid be unduly 
diminished, the earthy parts are no longer held in solution, 
and a tendancy to form white sand or gravel immediately com- 
mences. If, on the contrary, the acid be in greater excess 
than usual, instead of deficient, or if the natural secretion of 
the earthy constituents of the Urine be deficient, while the 
acid retain its usual measure, the acid itself has a tendancy tc 
form a deposit, and hence the modification of red sand or grave/ 



Gravel. 319 

thht id bo frequently found coating the bottom of chambci 
utensils. 

It is proper to remark that the red gravel is by far the most 
frequent kind of deposit, and the most effectual remedies for 
it are the alkalies, and the alkaline carbonates, such as lime- 
water, the carbonate of potash or soda, and magnesia. Bat tc 
be realy useful, they must be conjoined with a proper diet, ton- 
ics and mild purgatives ; for it ought never to be forgotten, in 
the treatment of gravel and stone, that they owe their formation 
ehieily to an irregular and vitiated action of the digestive or- 
gans, whieh will invariably require this conjunction, in order 
to the accomplishment of a permanently beneficial effect. 

Half a drachm, or a drachm of carbonate of potash, or soda, 
may be given dissolved in water, two or three times a day, 
with an alterative pill of blue mass, five grains, ipecac one grain, 
rhubarb three grains ; the following draught being taken every 
morning, or every other morning, as a gentle and suitable pur- 
gative. Take of Rochelle salt two 01 three teaspoonfuls, car- 
bonate of soda half-teaspoonful, water three tablespoonfuls — 
mix, and alter adding a tablespoonful of lemon-juice, or thirty 
grains of tartaric acid, let it be drank immediately. 

Magnesia, in this species of gravel, is of considerable use. 
It may be taken either alone, in doses of ten grains twice a day, 
or combined with the carbonate of soda, in the proportion of 
six or eight grains of the former, to ten grains of the latter, 
twice or three times a day. Or ten grains of magnesia may 
be dissolved in a glass of soda water, which is an excellent way 
of administeriiig it. 

Ten or fifteen grains of the carbonate of ammonia, twice a 
day form likewise a useful medicine, especially in cases where 
great languor, or weakness and coldness of the stomach, is 
present. The ammonia is a powerful corrector of ascidity, and 
a most valuable cordial. 

A very convenient and valuable mode of combining an al- 
kali with an aperient, and gentle bitter tonic, is the following; 
it is worthy of particular regard when weakness of the stomach, 
costiveness and red gravel are combined : take of carbonate of 
eoda ten grains ; Epsom salts half a drachm or a drachm; infusion 
(tea) of gentian, three tablespoonfuls ; tincture of cardamon seed 
a teaspoonful — mix for a dose, to be taken three times a day 
The bowels should be kept gently open by it, and, therefore, the 
Epsom salt may be either increased or diminished, as needed. 
Uva ursi is both tonic and astringent, and has been spoken 
well of, for its virtues in gravel and stone, by physicans of high 
authority It may be combined or alternated with the alkor 



320 Qravd. 

lies ; and where general debility exists, or there is a discharge 
>f pus-like matter from the bladder, denoting ulceration, or a 
faulty condition of its secreting vessels, it is at once an appro- 
priate and excellent medicine. The dose is from a half to one 
teaspoonful of the powder, twice or three times a day ; or a 
strong tea may be made by pouring hot water upon the leaves 
of the plant ; to three tablespoonfuls of which may be added 
ten grams of bi-carbonate of soda, and drank three times a day. 
In cases of white gravel, it may be given in conjunction with 
the nitric or mutriatic acid, ten drops to the pint of uva ursi 
tea, to be taken through a quill or straw, to protect the teeth. 

The diet of persons troubled with red gravel should be mod- 
erate in quantity, but of a nutritious and wholesome quality, 
consisting principally of fresh animal food and vegetables. 
All acids must be carefully avoided, and likewise heavy bread, 
fat meats, hard boiled puddings, and soups. 

Active exercise is of great importance in all gravelly dis 
orders ; and flannel should be constantly worn next the skin. 

Now, in regard to the cases of white sand or gravel, an acid 
is the best medicine, and all the acids seem to answer the pur- 
pose, though the muriatic, nitric, and citric acids, have been 
in the greatest repute. The citric acid, or lemon-juice, is pr>- 
ferable for children, as being the pleasantest, and that which 
may be persevered in for the longest time : it may be mixed 
with water in any proportion that is agreeable. The muriatic 
acid may be given in doses of from five to twenty drops, twice 
or three times a day, in a wineglassful of water; and the 
nitric acid in doses of from five to twelve drops, in the sama 
proportion of fluid, to be sucked through a quill or straw, to 
prevent injury to the teeth. 

The diet should be nutritious, easy of digestion, and mode- 
rate in quantity, and be as largely as possible intermixed with 
acids, salads, fruits, and especially oranges and lemons. Wa- 
ter, saturated with carbonic acid, to be found in most of the 
drag-stores, in the form of u carbonated water," is the best 
common beverage in this kind of gravel, and, attention being 
paid to diet and exercise, will sometimes be alone a sufficient 
remedy. 

When pain attends the gravei, opium or extract of henbane 
should be occasionally administered, according to the urgency 
of that symptom. Thirty or forty drops of laudanum, or twen 
ty of the solution of sulphate of morphia, or from five to ten 
grains of the extract of henbane, may be given alone, or in 
any drink which the patient may be taking, and repeated unti 
the pain is relieved. Opium seems generally preferable in thf 






Gravel 321 

vhite gravel ; and henbane in the red. In white gravel, the 
solution of acetate of morphia is particularly indicated as an 
anodyne, since the acid it contains is an appropriate and efficient 
remedy for the complaint, and, at the same time, counteracts 
the injurious effects likely to result from the frequent use of 
opium, when taken in any of its common forms. In case of 
great pain and irritation about the urinary organs, an opiate 
injection will be proper, and often of much service ; (ten to 
twenty drops of laudanum, in half pint of tepid water,) or two 
or three grains of opium may be made into a pill, and inserted 
within the lower portion of the bowel as a suppository. 

A burgundy pitch or galbanum plaster may be applied over 
the loins with advantage. 

Whether the gravel be white or red, when a small stone 
passes from the kidneys into the bladder, there is generally a 
fit of pain and irritation ; to relieve which, the warm bath, or 
hot fomentations of hops, wormwood, &c, together with forty 
or fifty drops of laudanum every three hours, will be the most 
proper and effectual remedies. The passing of a small stone 
from the kidneys to the bladder, is denoted by a fixed pain in 
the region of the affected kidney, with a numbness of the thigh 
on the same side. The pain is sometimes very acute, and ac- 
companied with nausea and fainting, but the pulse is rarely 
accelerated. During the whole of the passage from the kid- 
neys, the urine is usually high colored, and frequently mixed 
with blood. 

Stoke in the Bladder. — The symptoms of stone in bladder 
are, a sort of itching along the urethra, particularly at the 
extremity ; frequent propensities to make water, and go to 
stool ; great pain in voiding the urine, and difficulty in retain- 
ing it; the stream of urine being liable to stop suddenly, 
while flowing in a full current, although the bladder is not 
empty, so that the fluid is expelled by fits as it were ; and the 
pain being greatest towards the end of, and just after the eva- 
cuation. There is a dull pain about the neck of the bladder, 
together with a sense of weight, or pressure, at the lower part 
of the belly ; and a large quantity of mucus (or slime) is mixed 
with the urine, and sometimes the latter is tinged with blood, 
especially after exercise. 

The causes of stone in the bladder are the same as thoe 
which give rise to gravel. 

The medical treatment to be employed in cases of stone ia 
precisely the same as that for gravel, both in regard to the re- 
medies and diet. There is this difference between gravel and 
none, that, in the former, active exercise is highly advisable; 



322 Strangulated Hernia, or Bupture. 

whereas, during the actual presence of stone in the bladdeT 
the patient's exercise ought, for obvious reasons, to be less ac- 
tive and constant. 

An injection of castor oil has great effect in relieving tha 
suffering's occasioned by stone in the bladder; the introduc- 
tion of a lubricating fluid into the bladder, under such circum- 
stances, is productive of ease and advantage. One or two 
ounces injected when the bladder is empty, through a catheter 
Is about the proper quantity, used once in every two or throe 
days, as may be necessary. 

STRANGULATED HERNIA, or RUPTURE. 

As this is liable to occur at any time, in those who are rup- 
tured, if not protected by a proper truss, it should be care- 
fully studied, so that it can be detected in time to send fo* 
medical aid. When either an old rupture from some cause has 
become strangulated, or when some sudden exertion has at once 
produced rupture and strangulation, the following symptoms 
occur : there is a swelling at the place of the rupture, painful 
to the touch, and increased by coughing, sneezing, or by the 
upright posture. These symptoms are followed by sickness, 
retching, costiveness, with a frequent hard pulse, and other 
attendants of fever. The cause of these symptoms is the stric- 
ture made on the bowel, by the part through which it pro- 
trudes. The object of cure, is therefore to relieve the bowei 
from this pressure, which is to be effected either by returning 
the intestine into the belly, by the same aperture through 
which it came out, or by enlarging the aperture bf an opera- 
tion, which can only be done by a surgeon. 

Our first efforts should be to replace the bowel by the hand, 
if possible ; and various methods are to be put in practice, to 
produce the relaxation necessary for that purpose : place the 
patient on his back, with the thighs and knees bent; and 
make pressure on the tivmor in a direction obliquely upwards 
and outwards, if it be an inguinal hernia, (running obliquely 
ftiOng the lower portion of the abdomen,) but the pressure 
must at first be made downwards, towards the thigh, and thee 
ap wards if the hernia be femoral, (running down into the 
upper part of the thigh.) In a young and strong person, 
bleeding is very proper, both to induce relaxation, and to pre- 
vent inflammatory symptoms. The warm bath may be tried 
also to induce relaxation. With a view to diminish the bulk 
of the swelling, and so to render it more easily replaced, cold 
has been applied to the external parts, by means of ice or of 
other. An injection of tho infusion of tobacco produces at 



Ulcers, or Sores. 323 

extreme relaxation of the whole system, and so lias conduced 
to the reolaeement of protruded bowels. The strength of the 
in fusion is a drachm of the leaves to a pint of boiling Water ; 
this is infused for ten minutes ; one-half is injected at first, 
and the other a little afterwards, if no proper effect is produc- 
ed by the first. The tobacco injection is, however, a remedy 
of the greatest danger, and must never be administered, except 
hy an experienced practitioner. These attempts to reduce the 
bowel, may be made for a longer or shorter period, according 
fco the symptoms of each case. Much handling will add to 
the danger of inflammation which is already so great ; and 
too long delay will allow the bowels to get into a state of mor- 
tification. Always procure a physician in these cases, if possible. 

Ruptures in Infants. — Ruptures in different parts, espe- 
cially at the navel, are not unfrequent occurrences in infancy; 
fortunately, they are not attended with so much danger as 
similar disorders in grown people. When the disease is confin- 
ed to the navel, a broad piece of flannel, in the form of a 
roller, together with pieces of adhesive plaster applied over 
the part with a ball of cotton, forming what has been termed 
by surgeons a graduated compress, by affording a safe and firm 
support, prove so useful, that as the infant acquires strength, 
the rupture commonly disappears. The other varieties of rup- 
ture are often cured by the natural increase of size and 
strength in the body, and require chiefly attention to the due 
regulation of the bowels, and the daily use of the cold bath. 
!$o truss ought to be employed for at least the first two years 
of life. 

ULCERS, or SORES 

It may seem almost unnecessary to state that there are a 
great many varieties of ulcers, requiring a corresponding va- 
riety of treatment. We have first the 

Simple Purulent or Running Ulcer. — Some ulcers are 
covered with matter of a white color, of a thick consistence, 
and which readily separates from the surface of the sore. 
There is a number of little eminences covering the bottom of 
he ulcer, called granulations, which are small, red, and point- 
ed at the top. As soon as they have risen to the level of the 
•urrounding skin, those next the old skin become smooth, and 
are covered with a thin film, which afterwards becomes cloudy- 
looking, and forms skin. The principal thing to be done in 
the treatment of this kind of ulcer, is to keep the surface 
clean, by putting on a little dry lint, and a pledget (several 
folds of muslin) over it, covered with simple ointment, made 
of equal parts of lard, beeswax and tallow. In some patients, 



324 Ulcers, or Sores. 

ointment irritates and inflames the neighboring skin. Ban- 
dages sometimes irritate the sore, and disturb the healing pro- 
cess; but when they do not, they are useful in giving a 
moderate support to the parts, and in defending those mat 
are newly formed. 

Ulcers in Weakened Parts. Other ulcers are in parts 
which are too weak to carry on the actions necessary to their re- 
covery. In them, the granulations are larger, more round, 
and less compact than those formed on ulcers in healthy parts. 
When they have come up to the level of the healthy parts, 
they do not readily form skin, but rising still higher, lose alto- 
gether the power of forming it. When the parts are still 
weaker, the granulations sometimes fill up the hollow of the 
ulcer, and then are suddenly absorbed, leaving the sore as deep 
as ever. Ulcers are very much under the influence of what- 
ever affects the constitution ; and change of weather, emotions 
of the mind, and some other agents, quickly occasion a change 
in their condition. Such ulcers as we have been describing, 
require general as well as local treatment ; one grain of quin- 
ine three times a day, or a tea of dogwood bark, cold, in wine- 
glassful doses, and nutritious diet, are to be given ; and the 
granulations are to be kept from rising too much, by the pru- 
dent application of blue vitriol, lunar caustic and burnt alum, 
weakened sufficiently by proper admixture of ointment to 
act as stimulants, and not as caustics. This will give a pro- 
per and healthy action to the granulating surface ; whereas 
the destroying of the rising parts by caustics, seems rather to 
encourage the growth. Bandages and proper support to the 
parts, are highly useful. These ulcers, in weak parts, do not 
seem to be the better of poultices, or other relaxing applica- 
tions ; powders rarely do good, and perhaps the best dressing 
is the citrine ointment, (see " Medicines, their doses and uses), 
more or less diluted, if required. 

Irritable Ulcers. — There are certain ulcers, which may be 
called irritable ulcers. The margin of the surrounding skin 
is jagged, and termiuating in an edge which is sharp and 
undermined. There is no distinct appearance of granulations, 
but a whitish spongy substance, covered with a thin watery 
or milky discharge. Everything that touches the surface 
gives pain, and commonly makes the ulcer bleed. The pain 
sometimes comes on in paroxysms, and causes convulsive mo- 
tions of the limb. Such ulcers seldom do well without a fre- 
quent change of treatment. Fomentations with poppy heads, 
hops, chamomile flowers, or hemlock leaves, are sometimes of 
use in irritable ulcers. When poultices are prescribed, thej 



Wens. 325 

tshonld never be allowed to rest or bear weight on the sore 
limb. Powdered applications are generally too stimulating 
for irritable nlcers, and bandages also prove hurtful. Fre- 
quent washing with cold water, or pouring upon them a stream 
of cold water, will often be found beneficial in this variety of 
ulcers. A tea made of oak bark, mixed with tar water, wiL 
sometimes act like a charm in healing this kind of ulcer. 

Indolent Ulcers are those which have the edges of the 
•urrounding skin thick, prominent, smooth, and rounded. The 
surface of the granulations is smooth and glossy ; the matter 
is thin and watery, and the bottom of the ulcer is nearly level. 
A great proportion of the ulcers in hospitals are of the most 
indolent kind. Indolent ulcers form granulations, but fre- 
quently they are all of a sudden absorbed, and in a few hours 
the sore becomes as much increased in size as it had been 
diminished for many weeks. The principal applications re- 
quired for indolent ulcers are those of a stimulating nature, as 
the basilicon ointment, and occasionally sprinkling with red 
precipitate. Pressure is to be made by a roller, and by slips 
of adhesive plaster. Be careful to soften the dressings always 
before taking them off, by means of warm water or soap suds. 
The tea of oak bark and tar water is also advisable in this 
kind of ulcer, or the application of a wash made of a tea- 
gpoonful of blue stone in a pint of water once a day, or the 
lunar caustic, will sometimes be necessary. 

WENS. 

A description of these is here given for the benefit of the 
reader, in detecting tumors of this kind, not expecting any 
domestic treatment can often be successful. 

Tumors on the surface of the body are distinguished by 
surgeons according to the nature of their contents, and they 
require treatment varied according to circumstances. 

Wen is the common popular name for any fleshy excrescence 
or tumor growing on any part of the body ; most frequently, 
however, it is applied to tumors about the throat and neck. 

Sometimes wens are attached by a narrow neck, and may 
be removed by the knife, or by ligature (being tied with silt 
around its neck) ; at other times they have a broad base, and 
are so supplied with large blood-vessels that they cannot be 
removed at all, or cut, without the utmost risk. Sometime* 
wens are filled with a curdy or cheese-looking matter, and are 
contained in a cyst or bag, which must be dissected out, along 
with its contents, and the cut skin will heal and leave very 
iittle deformity ; in other cases, the tumor is fungus hwmatod&i 



326 Wry Neck — Varicose. 

or bloody cancer, which pretty certainly destroys the patient 
The bronchocele, or goitre, (on the front part of the neck,) is 
to be treated with iodine ointment, or tincture of iodine, ap- 
plied once every day or two, and the tincture of iodine inter- 
nally (ten drops three times a day in a gill of sweetened water, 
on an empty stomach). Sometimes very large wens contain a 
mixed substance, resembling fat or marrow ; they have a firm 
fleshy feel, and sometimes attain an enormous size. 

WB T NECK. 

This term is generally applied to a long-continued or per- 
manent turning of the head to one side. It is different from 
the pain and stiffness which occur from cold and rheumatism, 
and which prevent the free motion of the head. It arises 
from various morbid conditions of the part, either from distor- 
tions of the spine, from palsy of some of the nerves going to 
the muscles that move the head, or from some altered struc- 
ture of the muscles themselves. The removal of this affec- 
tion, when possible, is accomplished by treatment adapted to 
the particular cause inducing it. The bones of the neck may 
be aided by machinery, by which they can be kept in a pro- 
per position, if the subject is young ; blistering, friction, and 
shampooing, long persevered in, have been of service in the 
paralytic affections of the nerves and muscles ; and at one 
time it was a favorite practice to cut across the large muscle 
extending from the ear to the breast-bone, which was gene- 
rally supposed to be in fault. This severe measure very often 
was unsuccessful, and is hardly ever to be recommended, even 
when performed by the best surgeons. 

VAKIC OSE, or ENLARGED VEINS. 

This condition of the veins is found mostly in the lower ex- 
tremities, and is sometimes a troublesome and painful disease. 
Of course the longer it goes on without being cured the 
worse it becomes. The affection consists, essentially, in the 
Teins becoming elongated (or stretched longer), so as to permit 
of their assuming a tortuous, knotted condition, while they 
are at the same time enlarged. This state is usually associ- 
ated with obliteration or deficiency , more or less, of the valve* 
within the veins, so that the weight of the entire column of 
blood bears with distensive force upon the vessels, and upon 
those parts of them which are most dependent. The most 
frequent causes of the varicose veins, are such as cause impe- 
diment to the upward flow of the blood through the large 
rains of the abdomen. In this way, pregnancy, if frequent, 



Foreign Substances in the Byes. 327 

hb a most common exciter of the condition : habitual costive 
ness, diseases of the liver, tumors of any kind within the ab- 
iomen, act in a similar manner. The truss worn on account 
of rupture, or garters too tightly tied, likewise excite the vari- 
cose condition, which is usually more common in persons 
whose occupations require much standing, especially if they 
are tall. 

The veins and limbs generally should be supported by som« 
one of the forms of elastic stocking : these can now be ob- 
tained at so moderate a price, that none need be without their 
valuable aid. It is often surprising how immediately the use 
of well applied mechanical support, such as the elastic stock- 
ing affords, removes the uneasy and painful sensations con- 
nected with the condition of the veins in question. Some in- 
dividuals cannot, however, wear an elastic stocking of any 
kind ; for such cases, an elastic tape or bandage fixed to the 
foot by a stirrup, and wound spirally round the limb, has been 
successfully employed. Spaces of about three inches being 
left between the spirals, each time the band crosses the vein, 
it acts like a valve. 

Frequently a bandage of muslin or calico, wet and rolled 
moderately tight, beginning at the toes and going up the limb 
as may be requisite, will answer all purposes. It should be 
put on when the patient is lying down, and reapplied twice 
a day. Let the limb be plunged into cold water, or laid down 
and cold water poured over the limb, beginning at the toes and 
going along above the knee, each time before the bandage is 
applied. 

FOREIGN SUBSTANCES IN THE ETES. 

This is often the cause of much suffering as well as uneasi- 
ness of mind. Persons often go a long ways to a physician 
on account of some little substance getting into the eye, when 
the exercise of a little judgment and tact on the part of by- 
Itanders would save the patient time, expense, and suffering, 
by removing it before it had time to produce much local irri- 
tation. The membrane, which covers the inside of the lids 
and white of the eye, is, from its exposed situation, liable to 
become inflamed from various causes. Minute particles of 
dust or other substances getting into the eye, and becoming 
fixed in the lining of the upper eyelid, between it and the 
globe, cause an amo int of pain and irritation which could 
icarcely be credited from their size, but which is well ac« 
counted for by the accurate apposition of the two surfaces be* 
tween which they lie. A particle so situated may be discor- 



328 Stye—Sore Eyes. 

ered without much difficulty by a second party examining the 
sufferer with the head thrown back, while he slightly everts* 
(turns inside out), the upper lid with the thumb and finger 
The slightest speck of foreign matter must be removed, and no 
better instrument can be employed for the purpose than a 
piece of not over-stiff writing-paper twisted, or where it can 
be had, a camel's hair pencil. Those who work in metals are 
apt to get minute scales imbedded in the forepart of the ball' 
they cause much ii ritation, and are often so extremely difficult 
to remove that a surgeon's assistance is required. Pieces of 
iron or steel can often be removed by a magnet (loadstone), 01 
magnetized piece of iron : bringing it in contact with the foreign 
substance, it attracts it, and, adhering to the magnet is takeD 
out. Never rub the eye when there is dust or other foreign 
substance in it, it may injure the ball of the eye by friction. 

STYE. 

This is a boil or abscess in the lid of the eye, usually caused 
by the duct or opening leading from the little glands becom- 
ing obstructed. When once they make their appearance fchey 
are troublesome, as one attack after another is apt to follow. 
The treatment consists in mild purgatives, a spare diet, and 
local applications, such as warm fomentations of hops, etc., 01 
poultices in a muslin bag, lest the particles get into the eye. 
When it breaks and gets well, bathe the eye three or foui 
times a day in cold water. 

SOBE EYES. 

This being a disease of such frequent occurrence, and by 
being neglected or improperly treated, often occasioning loss 
of sight, every person should understand how to treat it. 

The first symptom of inflammation of the eve is a sensation 
as if a particle of some kind had lodged in the eye, and if an 
examination be made there will be seen, not 01: iy an enlarge- 
ment of any small blood-vessels that may be generally visible 
on the white of the eye, but a new development of others, the 
appearance varying from the slightest apparent increase of 
vascularity or fullness, to the most intensely red inflammation. 
At the same time there is considerable increase in the mucous 
secretion — not in the tears, as is often supposed — and in bad 
cases this becomes purulent or mixed with matter. There is, 
sometimes, considerable swelling of the surface, usually dis- 
tinguished as the white of the eye. The above is the most 
•uperficial form of inflammation to which the eye is subject; 
if neglected it may extend itself over the coic«w or froac part 



Sore Eyes. 329 

df the eye-ball and produce permanent blindness. It is undis- 
tinguishable from the next form, or inflammation of the scle- 
rotic coat, or whites of the eyes, by the size and winding char- 
acter of the small blood-vessels, and by their being slightly 
movable along with the conjunctiva, or membrane, itself, when 
the lids are drawn down. It is important that these distinc 
tive characters should be attended to in the first place, that 
no error may be committed between this form and a more 
ierious and deep-seated inflammation of the eye, and also that 
proper treatment may be used. A great error is committed 
*n treating this form of inflammation by means of warm 
fomentations, etc., applications tending rather to keep up than 
to cure the disease, which is generally quickly removed by 
astringents and cold applications. A drop of laudanum mixed 
with six of cold water, put in the eye, repeated two or three 
times will often cure the disorder; or a lotion of sulphate of zinc, 
from one to three grains to the ounce of water, will be found 
efficient ; but the best of all is the solution of nitrate of silver, 
or lunar caustic, of the strength of four grains to the ounce of 
water. Of this, a single drop may be introduced into the in- 
flamed eye twice or three times in the twenty-four hours., 
Great care should be exercised to get the exact strength here 
given, as it is a dangerous remedy if made too strong. The eye, 
of course, should be exercised as little as possible, and if the 
bowels are confined or the stomach disordered, five grains of 
blue pill every second night, followed the next morning by a 
eeidlitz powder or castor oil will be found useful. If the dis- 
ease is obstinate, a blister to the back of the neck may be 
applied with advantage. 

The disease which has just been treated of, is a compara- 
tively mild disorder, but under certain circumstances it be- 
comes much more virulent. The secretion of matter is very 
great, and acquires the power of propagating the disease by 
contagion from one person to another. 

Newly-born and young infants frequently suffer from a 
severe form of this disease, which often shows itself within 
three days after birth. The inflammation is intense, and the 
matter often accumulates largely between the lids, gushing 
out when they are separated. In scrofulous children especially, 
the affection is often obstinate. The nitrate of silver in solu- 
tion, is the best application, and small doses of quinine the 
best internal remedy. Syringing between the lids with a 
•olution of alum, four grains to the ounce of water, six or 
eight times a day, is also recommended. A little lard should 
be used on the edges to prevent them sticking together. 



330 



Defects of Vision. 



In inflammation of the sclerotic or outer coat of the ball 
itself (or whites of the eyes) there is more actual pain, it is 
more deeply seated, and the redness seen on the white of the 
eye is more of a pink hue than in the other form of the disease 
just treated of, the vessels appear much smaller and straighter, 
radiate as it were from the cornea or front of the eye, and are 
not movable ; the affection is generally a more se-ious one 
than the other. Active treatment is necessary ; leeches should 
be freely applied to the temples, or behind the ears, or capping 
on the back of the neck resorted to ; the bowels must be freely 
purged with ten grains of blue pill mixed with ten of rhubarb, 
followed next morning, if necessary, by a dose of castor oil or 
Rochelle salts, in the first instance, and then calomel in two- 
grain doses, given at intervals of six or eight hours. The diet 
must be reduced as low as possible, all stimulants avoided, 
every attempt at exertion even of the unaffected eye forbidden, 
and the person confined to a darkened room, the only local 
application being continued hot fomentation to the eye (of hops 
in a bag, on which hot water has been poured), and a blister 
between the shoulders. By a continuation of the above treat- 
ment, even till the gums get sore with the mercury, much 
may be done in cases where a physician can not be had, but 
where possible, a medical man should be called to attend 
to it. 

DEFECTS OF VISION. 

Long-Sightedness. — This is a condition of the vision often 
met with in aged persons. It consists in near objects being 
confusedly seen, while those at a distance can be distinguished 
very clearly. It is thought, usually, to depend on the eye be- 
coming flattened, from which results an alteration in the con- 
vergency of the rays of light, so that the "focus 1 ' is formed 
behind the retina, or the expanded nerve of the inner part of 
the eye. 

The defect is to be remedied by the use of convex glasses, 
which must be adapted to the eye by the individual affected. 

Short-sightedness, of course, is just the reverse, produced by 
the eyeball being too round or prominent / and is to be reme- 
died by the use of concave glasses, properly adapted to each 
individual case. 

While on this subject, we would take occasion to warn oui 
readers against reading in railroad cars, or any vehicle, whilt 
%n motion. It is very injurious to the sight, by the constant 
strain or effort to fix the " focus." Railroad conductors from 
tins cause have become blind. 

$ u would also warn the reader against the use of what hai 



Growing in of the Toe-nail— Inflammation qftlie Tonsils, 331 

been lately brought into use, by extensive advetrising, called 
14 eye sharpeners" to produce a greater convexity of the eye- 
ball, by applying the instrument to the front of the eyeball, 
Such things are very injurious to the eyes, in unprofessional 
hands. 

GROWING IN OF THE TOE-NAIL. 

This is a frequent and troublesome complaint, caused by the 
Hail pressing down into the soft parts, and kept up by its con- 
tinuance. It is generally the result of tight, or misshapen 
boots and shoes. 

There are many palliative methods of treating this affection, 
euch as the use of caustics, scraping the nail away, the appli- 
cation of poultices, etc. ; but perhaps there is no certain mode 
of treatment but the thorough removal of the entire half of 
the nail up to the root, on the offending side. This, of course, 
ought to be done by a physician. Wearing an " old shoe," or 
Loose slipper, or going barefooted for a while, will afford great 
relief, and sometimes effect a cure, especially if the foot is 
often soaked in water, and the nail scraped thin in the middle. 

INFLAMMATION OF THE TONSILS, or Sore Throat 

Sore throat of this kind usually commences with chilliness, 
and often flushes of heat ; the tonsils and back part of the 
throat soon become red, swollen, and painful. The pain is 
acute and darting, and usually extends to one or both ears. It 
is increased by every attempt to swallow, and by externa] 
pressure. These local symptoms are generally attended with 
some degree of fever. Swallowing is greatly impeded as the 
disease increases, and speaking, and even breathing, are en- 
dered difficult. In a few cases, small white spots are to be 
observed upon the tonsils. When the inflammation is very 
violent, the eyes become red, swollen and watery ; the cheeks 
flushed and swollen, and the .patient is unable to open his 
mouth. Externally, large tumors can be felt, or even some- 
times seen by the eye, on each side the jaws. The sense of 
suffocation is intolerable, and the patient is obliged to be sup- 
ported in an erect posture. 

When inflammation of the tonsil occurs repeatedly in the 
same individual, within a short space of time, a peculiar sus- 
ceptibility to the disease is established, so that it is produced 
by the slightest causes afterwards. 

The active symptoms in this disease may either rapidly de« 
elint or produce suppuration and an abscess in the throat; or 
remaining a long time in a chronic state, cause an enlarged 



332 Inflammation of the Tonsils. 

and hardened condition of the tonsils, by which sometime! 
breathing, swallowing and speech are so much affected as to 
require the removal of the organs by a surgical operation. 

At the very commencement of the attack, before the inflam- 
mation of the throat is of any considerable extent, an emetic 
of ipecac, ten to fifteen grains, given in warm water, will fre- 
quently be found to remove it at once. When, however, the 
disease has run some time, or is from the first of a violeni 

frade, bleeding, by leeches to the throat, will be demanded, 
his should be succeeded by a dose of Epsom salts or castoi 
oil, or when the act of swallowing is attended with great diffi- 
culty, a tablespoonful of the following mixture may be taken 
every two or three hours: Epsom salts, one ounce; nitre, 
(saltpetre,) one drachm ; tartar emetic, two grains ; and boil- 
ing water, twelve ounces. This, with the occasional use of the 
warm foot-bath, an injection of warm water, will have the 
effect of opening the bowels, producing a gentle perspiration, 
and reducing the inflammation. 

A variety of acid and astringent gargles have been proposed 
in this disease, but there are few cases in which the patient can 
make use of gargles in such a manner as to derive much ad- 
vantage from them. In general, more benefit will be derived 
from inhaling the vapor of warm water or vinegar and water, 
or of bitter herbs, &c, as ordered in catarrh in the head, which 
may readily be directed to the throat by means of a common 
funnel. 

If the inflammation should not be reduced by these means, 
a large blister is to be applied around the throat, or the thi oat 
may be enveloped for five or ten minutes with a cloth wet with 
spirits of turpentine. At the same time, the mixture directed 
above, with the inhalations, should be continued. 

Volatile and other liniments to the throat, which is so fre- 
quently resorted to in this disease, is productive of little good, 
and in some cases is even injurious, poultices seeming to afford 
more relief. 

The patient should be allowed nothing in the form of food 
m drink, during the disease, excepting barley, beef tea, soup, or 
gum water, rendered slightly acid by the addition of lemon-juice. 

When we discover that the swellings in the throat appear 
evidently inclined to suppurate, or come to a head, this should 
be encouraged by the frequent inhalation of the steam of hoi 
water, (as before recommended,) and in certain instances by 
poultices externally. The moment they become soft they 
ghould be punctured with a lancet, to allow of a dischaige of 
the contained matter. After this., a gargle of sage tea, alum 



Inflammation of the Larynx, 333 

and tuj.itfjj several times in the course of the day, will con* 
plete thu cure. 

We shotuu Lear in mind the great liability to a recurrence 
of the disease, which will point out the importance of the 
patient being un his guard for a considerable time subse- 
quently to his ncovery, against exposure to cold or damp, to 
•adden transitions of temperature, &c. 

Bathing the thruut night and morning in cold water is a 
good means of prev caring a return of the disease, in those who 
nave been subject to ii. 

IN FLAMMATION OF THE JLABTNX; 

(Or top of the Windpipe.) 

This commences with the visual symptoms of fever, from 
irritation or local inflammation. The voice very quickly be- 
comes hoarse and indistinct, sometimes entirely extinct ; the 
breathing laborious, with a painful sense of constriction in the 
throat ; on examining the back part of the throat, we now 
find that every portion of it is of an intense, dark red color, 
and considerably swollen. The face soon becomes red and 
bloated, the eyes red, swollen and often protuberant, as in 
cases of strangulation. The pulse is very quick and frequent, 
and the tongue coated. Every attempt to swallow is attended 
with intolerable distress ; the muscles of the throat and chest 
being thrown into violent spasmodic action, threatening the 
patient with instant suffocation, and causing him to cry out 
for the admission of more air into the room. 

This disease is extremely acute and rapid in its progress, 
often destroying life, by suffocation, in a day or two, or even 
in less time, unless attacked in its very commencement by the 
aiost active remedies. 

In many of its symptoms it bears a close resemblance to 
croup, and to distinguish the in from each other is not always 
very easy. This, however, is not of much importance, as the 
treatment of the two diseases does not differ in any important 
particular. 

This is an affection which calls for the exercise of the most 
energetic and best-directed medical treatment as soon as it can 
be procured. But it is of the highest importance that no time 
ihould be lost, even while waiting for that aid, and that some 
properly directed means should be at once resorted to. First, 
From half a dozen to two dozen of leeches, according to the 
itrength of the patient, should be applied to the throat antf 
uppei par 1 ; of the chest ; or, if leeches cannot be obtained 



334 CM in the Head. 

from six to twelve ounces of blood are to be taken from tha 
back of the neck by cupping. Tarter emetic, in eighth of a 
grain doses, or twenty drops of antimonial wine, is to be re- 
peated at intervals of from one to two hours, at first, and 
calomel given in four grain does every four hours, with a 
quarter of a grain of opium in every, or every second dose, 
anould purging ensue. Hot bran poultices are to be kept 
constantly to the throat, the feet put in hot water, and advan- 
tage may be derived from breathing the steam of hot water, 
and bitter herbs, &c, as recommended under the head of Ca- 
tarrh in the Head ; the patient, of course, being kept perfectly 
quiet in bed. These measures will do all that can be done until 
the arrival of a physician. 

COLD IN THE HEAD. 

It is unnecessary to give the symptoms of this disease, as they 
are too well known to all by frequent and unpleasant expe- 
rience. However familiar we may be with this disease, yet 
we should not look upon it as a trivial affair. From its ten- 
dency to recur, and also to produce and keep up irritation of 
the lungs, it is not only not to he neglected, but should be 
kecked at first, if possible, and for this purpose various me- 
thods of treatment are recommended. The injection of a 
solution of sulphate of zinc, five grains to the ounce, into the 
nostrils, at the very commencement of the disorder, has been 
said to stop it without fail. A teaspoonful of paregoric > or 
six or eight grains of Dover's powder, when taken at bedtime 
repeated for two or three nights, will often check a cold in the 
head at once ; and the usual system of hot foot-baths, confine- 
ment to bed, low diet, and diluent drinks, along with boneset 
tea, is certainly calculated to mitigate the disorder, and may 
be followed with advantage. It is the common practice to 
drink copiously of tea, gruel, or some other diluent during a 
cold ; as long as this promotes perspiration it is of some utility, 
and although it augments the flow from the nose, it has the 
effect of diminishing its acrimony or irritating qualities, by 
dilution. It is the acrimony of this discharge, which reacting 
on the membrane, keeps up the inflammation, and its accom- 
panying disagreeable symptoms. On this circumstance de- 
pends the efficacy of a measure directly opposed to that jurt 
noticed — we mean a total abstinence from liquids in any 
shape, water, tea, coffee, milk, beer, &c. To those who have 
the resolution to bear the feelings of thirst for thirty-six of 
forty -eight hours, we can promise a pretty certain and com* 
plete riddance of their colds, and what is, perhaps, more iru 



Cold in the Bead. 335 

portant, a prevention of those coughs which commonly succeed 
to them. Nor :s the suffering from thirst nearly so great as 
rnigh + be expected, especially when apiece of orange or lemon 
peel, sassafras bark, or something of the kind is kept in the 
mouth. This method of cure operates by diminishing the 
mass of fluid in the body to such a degree that it will no Ion- 

§er supply the diseased secretion. Anything that will contri- 
ute to reduce the quantity of fluid in the body will assist in 
the plan of cure, and shorten the time necessary for it to take 
effect. It is therefore expedient to begin the treatment with 
a purgativ e of salts, followed by a sweat at bed-time, as is 
usual, and this is the more necessary when any fever attends ; 
but beyond this no further care need be taken, and the indi- 
vidual can devote himself to his usual employments with much 
greater impunity than under the ordinary treatment. The 
coryza, or running from the nose, begins to be dried up about 
twelve hours after leaving off liquids ; from that time the 
flowing to the eyes and fulness in the head become less and 
less troublesome ; the secretion becomes gelatinous, and be- 
tween the thirtieth and the thirty -sixth hour ceases altogether: 
the whole period of abstinence need scarcely ever to exceed 
forty-eight hours. It is then as well to return to the moderate 
use of liquids, as the first indulgence is apt to be excessive. 
It is not necessary to limit the solid food any more than to 
that which is plain and simple, except where there is an accel- 
eration of the pulse, or irritation of the stomach, in which 
cases animal food should be avoided. For the sake of comfort 
in mastigation, the food should not be of the driest kind. 
Thick puddings and vegetables, with or without meat, will bo 
the best dinner ; and toasted bread or biscuit merely moistened 
with tea or other liquid for other meals. 

A single cup of tea is sufficient to bring back the coryza, or 
watery discharge from the nose, immediately, after twelve hours' 
abstinence has removed it. We doubt not that it will be said 
that this plan of cure is worse than the disease, and so it may 
be in s^me instances. It may be called always a choice of 
evils; but we do not believe that any one who is liable to 
severe colds, after once experiencing the amount of good and 
evil resulting from this method, would hesitate between them. 
Moderation in liquid food, is one of the best preventative 
against the bad effects of exposure to cold. When there is a 
large quantity of liquid in the system, there must be increased 
perspiration^ and therefore greater risk from the effects of 
cold. Nature seems, to some extent, to provide for these 
changes in the atmosphere, as in cold weather we drink but 



336 Inflammation &f the Lungs. 

little, and in warm weather drink more, as by the evaporatioi 
brought about by perspiration, the temperature of the body is 
i educed or kept down. 

INFLAMMATION OF THE LUNGS, {Pneumoniae 

Inflammation of the lungs commences with the usual symp« 
toms of fever : a feeling of coldness or shivering, succeeded by 
increased heat and dryness of the skin, thirst, flushed face, 
furred tongue, and increased frequency of the pulse. In some 
cases, however, there is little or no increase of heat, and the 
pulse is not more frequent than natural. Very soon a diffi- 
culty of breathing is experienced, and a pain, more or less 
acute, in some part of the chest, increased upon inspiration, 
(taking air into the lungs,) and in particular positions of the 
body. Occasionally the pain is dull, or rather there is a feel- 
ing of weight and oppression in the chest, rather than of pain. 
The pain is commonly fixed, but sometimes shoots towards 
the shoulder, or upper part of the breast. It is invariably 
accompanied by a short, dry, distressing cough, which greatly 
aggravates the disease. In the beginning of the disease, the 
cough is seldom accompanied with much expectoration ; a 
little frothy mucus is generally, however, brought up by it, 
which, in the course of the disease, is often streaked with 
olood. Subsequently, however, an expectoration of yellowish 
thick matter takes place, which becomes whiter, softer and 
more easily brought up as the disease progresses. The fore- 
going symptoms are of greater or less violence, according to 
the extent and intensity of the inflammation. 

A favorable termination of the disease is indicated by a 
gradual subsidence of all the symptoms. The respiration 
becomes more free, the expectoration more copious, the cough 
less frequent and distressing ; the fever disappears, and the 
pulse becomes softei and less frequent. The disease is some- 
times suddenly arrested by a spontaneous discharge of blood 
from the nose, or a very copious expectoration of a thick, 
yellow-colored mucus, brought up without much cough ; and » 
gometimes, but more rarely, by the appearance of an eruption 
on the skin. 

We should fear a termination of the disease by abscess, b> 
the obstinacy and but little violence of the symptoms, and then 
not yielding to an appropriate treatment within the first four or 
five days, and if there be but little expectoration, or especially 
11 delirium, with a soft, undulating pulse, supervenes. Where 
suppuration, or abscess, has actually taken place, the syrnp 
toms are, frequent, slight shiverings, a mitigation or cessation 



Inflammation of the Lungs. 337 

of the acute pain, with a continuance of the cough and a diffi- 
cult}- o^ breathing ; the pulse being soft, fuller, and either 
slower or more frequent ; by a redness of the cheeks and lips, 
an increase of thirst, and other symptoms of fever towards 
evening. An abscess being formed in the lungs, the breath- 
ing becomes very short and laborious, and attended with 
rattling in the chest ; the cough short, dry and obstinate ; the 
patient is able to lie only on the affected side ; the urine is 
muddy, the countenance pale, the body becomes quickly 
emaciated and enfeebled, and night-sweats and diarrhoea make 
their appearance. When the abscess is situated on the exter- 
nal surface of the lung, immediately beneath the ribs, a soft, 
indistinct swelling may be sometimes felt externally, with an 
evident fluctuation of matter. In such cases, an opening may 
be made into the abscess, between the ribs, the matter dis- 
charged; and the life of the patient frequently preserved. This, 
of course, can only be done safely by a physician. When the 
abscess is deeper seated in the substance of the lungs, in may 
burst into the air-cells of the lungs, and if it do not imme- 
diately cause the death of the patient by suffocation, the mat- 
ter may be discharged by expectoration, and the patient be 
finally restored to health. 

This disease requires prompt treatment, and of course if 
possible, a physician should be called at the earliest moment. 
When one is not to be had conveniently, let no time be lost, 
but pursue the course here marked out, which in a great many 
cases will be the means of curing the disease, or checking it 
while medical aid is being procured. Open the bowels by 
means of an injection, and also giving some mild purgative, 
such as castor oil, Epsom or Rochelle salts, or rhubarb. Ap- 
ply leeches, ten to twenty to the side affected, if they can be 
procured ; if not, scarify and apply the cups, after which a 
warm poultice of bran, Indian meal, or linseed meal or slip- 
pery elm, etc., to be sprinkled over with a little laudanum or 
paregoric ; to be applied frequently. Small doses of ipecae 
either in powder or the syrup, should be given every three 
hours, just so as to produce slight nausea but not vomiting. 
When this has been continued for about twelve hours, then 
use the following mixture : water, eight ounces (about one 
gill) ; syrup of ipecac, one table-spoonful, or live grains of the 
powder; chlorate of potash, one drachm, or about one tea- 
spoonful ; spirits of nitre, two tablespoonfuls. Dose : a 
teaspoonful every three hours ; if much sickness of the ato- 
mach is produced, not so often. Let the patient have plenty 
of cooling drinks, such as flax-seed tea, gum arabic, or slip 



338 Pleurisy — Inflammation of the Stomach. 

pery elm water, toast water, etc. The bowels to be moved 
occasionally by a dose of castor oil. 

FLE UBIS r. 

The symptoms of this disease are very similar to those of 
inflammation of the lungs, at least, requiring usually a phy- 
sician to tell the difference. However, the treatment recom- 
mended for that disease, is adapted in every respect for -pleurigj 

INFLAMMATION OF THE STOMACH. 

Though not a very frequent disease, this is a very painftil 
and dangerons one. The symptoms are marked by a more or 
less acute pain and feeling of burning in the region of the 
stomach ; these symptoms are aggravated by every thing 
taken into the stomach, by the motions of the body, and by 
pressure. 

Inflammation may come on very gradually, or be suddenly 
developed, according to the causes by which it has been pro- 
duced. When the disease is fully developed, the pulse is very 
small, hard, and frequent ; there exist great anxiety, oppres- 
sion, and a greater prostration of strength than in most other 
acute inflammatory affections. Every thing taken into the 
stomach occasions vomiting with painful Teachings. Hiccup 
is also an early symptom. The features of the face are con- 
tracted, shrunk, and altered from their natural expression. 
There is distressing thirst, a continual tossing of the body, 
constant wakefulness, and in general a costive state of the 
bowels. In violent cases there is difficulty of breathing, with 
increase of pain on a deep inspiration. In the course of the 
disease, fever, with intense heat of the skin is sometimes 
developed, and at others, delirium, convulsions, and stupor. 

Inflammation of the stomach is produced by large draughts 
of cold fly ids taken when the patient is in a profuse perspira- 
tion, or ever-fatigued by exercise ; cold applied externally, 
under similar circumstances ; contusions or blows upon the 
abdomen, intemperance in eating ; hard or irritating articles 
taken into the stomach, the violent operation of emetics ; or 
the excessive use of ardent spirits. 

Inflammation of the stomach is always a dangerous com- 
plaint, terminating fatally, when violent, in the course of a 
few hours, or when less acute, producing a long series of 
distressing and painful symptoms, and causing incurable 
disorganization ot the stomach, or by sympathy, producing 
disease of the skin, joints or brain; therefore it is all-important 
that it be treated in every case with promptness and energy 



Inflammation of the Bowels. 339 

T\u region of the stomach should be covered with leeches, nnd 
the flow of blood encouraged after they have fallen off, by 
warm fomentations. This treatment is the one adapted to the 
more acute cases, the important object being to reduce the 
inflammation with as little delay as possible. In all cases of 
inflammation of the stomach leeches are an important and 
mdispensab.e remedy, and they should be repeated again and 
again, until the local symptoms are entirely removed ; their 
number and the intervals of their application being adapted 
always to the urgency of the disease, and when some degree 
of inflammation still remains, the region of the stomach may 
be covered with a blister. In regard to internal remedies, 
there is none, with the exception of minute portions, frequently 
repeated, of cold gum arabic water, or iced water, but what 
would have the effect of irritating the stomach and increasing 
the inflammation. The vomiting and sense of burning by 
which the patient is often so much distressed, can be relieved 
only by the leeches, and by the cold fluids just alluded to. In 
some cases, advantage has been derived from a teaspoonful of 
powdered ice slowly swallowed, and occasionally repeated. 

Bathing the feet in warm water, and the application of 
mustard to the ankles, will, in some cases, be found beneficial. 
The bowels should be kept regularly open by injections of 
warm milk and water, or soap suds, etc. 

Chronic inflammation of the stomach is to be treated by the 
judicious application of leeches, by a very spare diet, of barley- 
water, gum-arabic water, tapioca or panado; by blisters to the 
region of the stomach, by the warm bath and frictions of the 
skin, and by gentle daily exercise in the pure open air, friction 
over the region of the stomach, etc. 

INFLAMMATION OF THE BOWELS. 

This disease, in its symptoms, does not differ widely from 
the foregoing, and perhaps in a majority of cases, at least in a 
partial degree, accompanies it. Inflammation of the bowels 
usually commences with a slight chill, and a sense of uneasiness 
in some portion of the abdomen, at first intermittent, but gra- 
dually becoming permanent, and finally changing to a fixed 
pain which spreads over the whole abdomen. The latter is 
somewhat swollen, and sore to the touch. Obstinate costive- 
ri ess generally attends the disease, and sometimes sever* 
vomiting. The pulse is very small, hard and frequent, and the 
tongue dry andjurred. The thirst is extreme, the urine high- 
colored, small in quantity, and most commonly discharged 
with iifficulty. The breathing is short and laborious, and the 



340 Inflammation of the Bowels. 

patient generally lies upon his back, with his knees drawn up 
towards his breast. If the disease be allowed to proceed, these 
symptoms augment in violence. The abdomen beccmei 
greatly distended with air, small mucous discharges take place 
from the bowels, with considerable straining ; the action of 
the bowels sometimes becomes inverted, and the contents of 
the bowels are discharged by the mouth. Suddenly the 
gony of the patient ceases, he appears to have obtained 
Telief from his disease, but his intermittent and scarcely per- 
ceptible pulse, the paleness and livid hue of his face, the icy 
coldness of his extremities, and other alarming symptoms, 
indicate that mortification has taken place, which is quickly 
succeeded by death. 

Inflammation of the intestines may be distinguished from 
colic by the presence of more or less fever, by the fixed and 
continued pain, increased upon pressure, and by the hard, 
frequent pulse. In colic, there is no fever, the pain comes ou 
in paroxysms, with distinct intervals of rest, and ; s diminished 
rather than increased by pressure. 

In the treatment of this disease leeches are to be applied 
over the seat of the pain, and repeated so long as the locv! 
symptoms remain, and the strength of the patient will perm} c 
followed by a blister. The same cold fluids internally, wl) 
be proper, as those ordered in inflammation of the stomacl 

After the violence of the inflammation has been reduce 1 4 
four grains of calomel, every two hours, should be given, con- 
bined with mucilage of gum arabic, until a copious evacuation 
from the bowels is obtained; the operation of the calomel 
>eing aided by laxative injections (See Medicines, their uses 
and doses). In some cases, fifteen grains of calomel with two 
of opium, will produce a very prompt evacuation, and relieve 
greatly the remaining symptoms of the case. 

During convalescence from inflammation of both stomach 
and bowels, the greatest caution must be observed, by a mild, 
well-regulated diet ; abstinence from all stimulating drinks ; 
by guarding against exposure to cold, and over exertion of the 
body ; by keeping the bowels regular, and using gentle daily 
exercise in the open air, wearing flannel next the skin, sponge 
ing the body with water once a day, followed by friction 
with a rough towel, etc. 



Diseases of the Liver. 341 

DISEASES OF THE LIVER. 

Acute Inflammation. — As in other forms of inflammatory 
diseases this is generally ushered in by a chill, succeeded by 
all the symptoms of fever. To these are soon added pain in 
the region of the liver, sometimes acute and shooting, with a 
sense of fullness in the right side ; at others, fixed and severe, 
or deep-seated. The pain commonly extends to the breast, 
collar-bone, and shoulder of the right side. The pain in the 
side is increased by pressure, especially when the patient lies 
upon his left side. The pain is often increased during breath- 
ing, and it is in consequence often impeded, more especially 
when the portion of the liver in contact with the diaphragm 
is inflamed. A severe cough is then also generally present, 
and in the course of the disease, hiccup commonly occurs. 
The cough in this disease is usually dry, short and fre- 
quent. 

From the cough and difficulty of breathing, which so often 
attend inflammation of the liver, it is often mistaken for in- 
flammation of the lungs ; happily, the treatment of the two 
diseases does not materially differ. The skin, eyes and urine 
have the same deep yellow tint as in jaundice. The pulse is 
various, being sometimes small and feeble, at others, full and 
strong; but most commonly hard. The urine is ordinarily 
high-colored, the heat of the skin and the thirst considerable ; 
the mouth dry, and the tongue coated with a yellowish mucus, 
which, in the course of the disease, becomes often dark brown 
or even black. There is likewise wakefulness, restlessness, and 
in a few instances, delirium. 

A favorable termination is often preceded by a discharge of 
blood from the nose, or from piles ; sometimes by a copious 
perspiration, or increased discharge of mucus from the lungs. 
A copious flow of deep-colored urine, occurring about the 
fourth day, and depositing, after standing, a red or whitish 
sediment, is also a favorable symptom ; the same is true of 
free bilious discharges from the bowels. 

From the obstinancy of the symptoms, we are to fear an ab- 
scess. As soon as it is formed, the acute pain in the side is 
changed into a feeling of weight and pulsation ; the former 
being increased when the patient lies upon the left side. There 
are also frequent irregular shiverings, and finally, all the 
bymptoms of hectic fever. When the abscess is seated on the 
external surface of the liver, a tumor and fluctuation of a fluii 
can be detected just below the ribs, on the right side, and by 
an incision, the matter may be evacuated, by which the chance 
of the patient's recovery will be greatly increased. When the 



342 Diseases of the Liver. 

abscess is more deeply seated, an adhesion taking place be- 
tween the liver and intestines, the matter may find its waj 
into the cavity of the latter, and be discharged by stool. In 
this case, the patient often recovers. 

Its most common causes are the action of excessive heal 
upon the skin ; sudden changes of weather; the sudden ap- 
plication of cold or damp to the body when heated ; contu- 
sions or violent blows upon the head or other parts of the 
body ; the excessive use of wines and spiritous liquors ; high 
living, and intemperance generally ; violent passions of the 
mind, particularly anger and rage ; the suppression of various 
habitual discharges, and irritations of the stomach generally. 

In the treatment of this form of liver disease, which is an 
inflammation, the treatment is the same as for inflammation 
of the lungs, bowels, &c, excepting that calomel or blue pill 
should be made use of freely in this disease, and the leeches, 
&c, applied to the region of the liver. The other general 
treatment is the same, as far as can be undertaken, without 
the advice of the attending physician. 

Chronic Inflammation of the Liver. — This is attended by 
the same symptoms as the acute, but assuming a more obscure 
and insidious character, and are more slow in their progress. 
In conjunction, also, with the peculiar symptoms produced by 
the disease of the liver, we have also those of ordinary dys- 
pepsia — wasting ; defective or variable appetite ; acidity ; fla- 
tulence ; feeling of fullness or uneasiness about the stomach t 
dry, harsh, and discolored skin ; disturbed sleep ; great de- 
pression of spirits, despondency, irritability of temper; irre- 
gular bowels ; disinclination to exertion, whether mental 01 
bodily ; indeed, all that train of symptoms to which the inde • 
finite term nervous is so generally applied. Ordinarily, 
chronic inflammation of the liver is attended with considera- 
ble difficulty of breathing, and a short, dry, teasing cough; 
sometimes, however, the cough is attended with expectoration. 
There is frequently a decided paroxysm of fever towards even- 
ing ; more or less yellowness of the skin, and when the disease 
has been of long continuance, night-sweats, great emaciation 
and a wasting diarrhoea. Chronic inflammation of the liver 
may either produce a great enlargement and hardening of the 
liver, perceptible to the eye and feel externally, or it may ter- 
minate in suppuration, (coming to a head,) the matter being 
discharged in the same manner as in the acute form of the 
disease. In most cases, chronic disease of the liver is attended 
with dropsy, either externally or of the abdomen, or both ; a 
species of chronic dysentery, with ulceration of the bowela 



Inflammation of the Kidneys. 343 

«ometimes takes place; and again, in other cases, from the 
operation of various causes, but particularly indulgence in 
ardent spirits, chronic inflammation of the liver may be ren- 
dered acute, when it is rapid in its course, and generally fata^. 

In its early stage, local bleeding by cups or leecnes, applied 
over the liver and stomach, ana repeated according to circum- 
stances, followed oy ousters to the right side, in conjunction 
with a very light vegetable diet, the warm bath, and friction 
to me surface : with a pill everv night and morning of the 
hlue mass, five grains : soap, three grains ; ipecac, one grain . 
and aloes, two grains, aided in its operation upon the bowels 
by an occasional dose of castor oil, or laxative injections. wiL 
^ery speedily remove the disease, provided the patient, at the 
same time, take gentle exercise, when the weather will per- 
mit, daily, in the open air — his body being defended from any 
sudden diminution of temperature by appropriate clothing, 
especially flannel next the skin. A permanent drain from the 
side, by Inserting an issue or seton over the liver, has occa- 
sionally been found beneficial. 

In cases or chronic affection of the liver, the dandelion has 
been strongly recommended by various practitioners ; it may 
be given in the form of extract, five to ten grains three times 
a day, or a gill of the strong decoction, or tea, cold. 

A bath of the nitro-muriatic acid is strongly recommended 
by some physicians. It may be applied either to the legs and 
feet, or by sponging, with the acid diluted with water, the 
whole surface of the body. The use of the remedy should be 
persevered in for a length of time. 

In this form of disease the food should be very light but 
nourishing, easy of digestion, and taken in small quantities at 
a time. Milk, rice, potatoes, and especially a free use of 
tomatoes, cooked or raw, twice a day, should be allowed. 
Avoid cold and dampness, and be careful to keep the bowels 
open at all times. A sea voyage is sometimes of great service 
In this disease. Out-door exercise should be taken daily. 

INFLAMMATION OF THE KIDNEYS. 

The symptoms of this disease are a feeling of heat, uneasi- 
aess, and a dull, or sharp pain about the loins,, and often a 
dull pain in the thigh, of one side, and great stupor or heavi- 
ness. The urine is at first clear, and afterwards of a reddish 
color, often bloody, and voided frequently, and in small quan- 
tities at a time. The urine generally coagulates, or becomei 
Inmpy by heat. The disease is often attended with vomiting, 
costi veness, difficulty of breathing, and cold extremities. Them 



344 Inflammation of the Bladder. 

is s painful feeling of uneasiness when the patient is sitting 
upright, or standing ; the easiest position being that of lying 
on the tide affected. If the inflammation of the kidney be 
eev 1 re, or occur in a broken-down constitution, it most com- 
monly gives rise to more or less dropsy, either externally, or of 
the abdomen. 

J iflammation of the kidneys may be induced by cold ; by 
habits of intemperance ; by the use of powerful diuretics, at 
spirite of turpentine, cantharides, &c. ; by bruises or sprain* 
cf the back or loins; gravel; violent or long-continued rid 
ing. <fcc. 

When the local symptoms are severe, the patient possessed 
of a considerable degree of strength, cups or leeches should be 
applied over the kidneys, and repeated until the disease is 
broken up. The use of the warm bath, or fomentations of 
hops, or horehound and vinegar, to the loins, constitute an im- 
portant remedy, after cupping or leeches, and should be re- 
peated daily. A mild purgative, as an ounce of castor oil, or 
a dose of salts, with the addition of one drachm of lemon-juice, 
in the dose of a table-spoonful every two hours, should be 
given, so as to keep the bowels regularly open, with frequent 
emollient injections of flaxseed-tea, infusion of slippery elm or 
thin starch, &c. 

The patient should make use plentifully of thin gum arabic, 
or barley water, or flaxseed tea, and abstain from all solid and 
irritating food, and stimulating drinks. In case of violent 
pain continuing after the cupping or leeches, a grain of opium, 
or two of hyoscyamus may be administered at bed- time. A 
decoction or tea of the dried leaves of the peach tree has 
been said, when taken to the amount of a pint a day, in many 
cases, to produce considerable relief. They are best given 
mixed with the uva ursi leaves. 

If the disease become chronic, the insertion of an issue or 
eeton at the loins, and internally twenty to thirty drops of 
balsam copaiba, or one teaspoonful of powdered uva ursi, or 
i gili of the tea (cold) made of the same, will have sometimes 
a most happy effect. 

INFLAM3IATION OF THE BLADDER. 
This disease is characterised by a feeling of fullness, un- 
easiness, ai; i pain in the region of the bladder, and a frequent 
desire and great difficulty in discharging the urine, often a 
total suppression, with frequent ineffectual efforts to evacuate 
the bowels, occasioned by the irritation extending to the lowei 
part of the bowel. These symptoms are generally accompa 



Mumps, 345 

aied with fever, sickness and vomiting ; great anxiety and 

restlessness : sometimes delirium, coldness of the extremities, 
and clammy perspiration ensue. 

The mucus or lining membrane of the bladder, is likewise 
affected with a chronic inflammation ; in these cases, there ii 
a dull, uneasy sensation in the part, frequent desire to pass 
urine, which is generally thick, from being loaded with mu- 
cus; sometimes bloody, or, if ulceration of the bladder has 
taken place, mixed with matter. The coats of the bladdei 
become often, when effected with chronic inflammation, thick- 
cued, or hardened, and otherwise disorganized, giving to the 
patient great uneasiness, and causing a constant inclination to 
n-inate, or a total suppression of the urine. 

In the acute variety of the disease, the early employment 
or* leeches over the region of the bladder, followed by the 
v arm bath and fomentations, will be required. The bowels 
si ,ould be kept gently open by mild laxatives and emollient 
h jections, as directed in inflammation of the kidneys. The 
1c eching should be repeated until the pain and uneasiness of 
H e bladder are subdued. During the disease, the patient 
s) ould observe a very low, unirritating diet, and make use of 
gi me mucilaginous fluid for drink. Any of those mentioned 
ii the preceding article may be employed. If the urine be 
w fcained so as to cause distension of the bladder, the catheter 
* til have to be used to draw it off. The patient must keep 
perfectly quiet, avoiding all manner of exertions of mind or 
b >dy, during this disease. 

When the case is chronic, leeches or cups, applied occasi- 
onally to the region of the bladder, will be advisable; the 
bowels should be kept open, and a warm bath taken twice a 
u eek at bed-time. Opiates, as ten drops laudanum, half tea- 
spoonful of paregoric, or ten grains of Dover's powders, at 
bed-time, will be necessary to ease pain and procure rest. 

MUMPS. 

This is a very common affection : it is a painful imflamma- 
tion of the parotid glands, situated behind the angle of the 
jaw, and often extending lower down. Though sometimes 
confined to one side of the jaw, it usually occurs on both sides ■ 
it is at first clearly defined and moveable, but soon become 
fixed, and spreads to a considerable extent. It increases in 
*izs till the fourth day, and often involves the neighboring 
glands in the inflammation ; it is supposed to be contagious, 
and often prevails as an epidemic. After the fourth day, the 
swelling gradually declines ; aiid. foi tne most part, it is unat- 



346 Angina Pectoris, or Breast Pang. 

IcLded throughout with fever, and scarcely ever calls foi 
medical aid. As the swelling of the throat subsides, it not 
nnfrequently happens, that a swelling takes place in the pri 
vates of males, and in the breasts of females. 

Generally, all that is requisite in this affection is, to keep 
the head and face moderately warm, to avoid exposure to cold, 
to observe a mild diet, and to open the bowels by a very gen* 
tie purgative, as a dose of magnesia, rhubarb, or salts. 

When the privates and breasts simply enlarge, they ought 
not to be interfered with ; but should they be painful, and 
tend to suppurate or break, a purgative of Epson salts, or 
"Rochelle salts should be given, a few leeches applied, and af- 
terwards a warm poultice. 

Should high fever occur, with other alarming symptoms, the 
usual means of reducing inflammation must be applied — purg- 
ing, small doses of ipecac, every two hours, with cooling 
washes, such as green tea (cold), tea of mullien leaves, &c. 

ANGINA PECTORIS, or BREAST PANGf 

(Pain in the Breast.) 

This disease has been called by several names, as will be 
geen above. It is a disease characterized by a sharp pain and 
oppression, seated at the lower end of the breast bone, inclin- 
ing to the left side ; it comes on in paroxysms, and is accom- 
panied with great uneasiness, difficulty of breathing, violent 
palpitation of the heart, and a sense of impending suffoca- 
tion. 

In the first stage of the disease, the pain is felt chiefly after 
some exertion, as going up stairs, or up a hill, or walking 
quickly, particularly when the stomach is full ; but in the 
more advanced stages, slighter exertions are sufficient to cause 
a paioxysm of pain, as walking, riding, coughing, sneezing, 
01 speaking ; passions of the mind also have the same tenden- 
cy. In the first stage, the uneasy and threatening symptoms 
soon go off ; but afterwards they continue longer and are more 
distressing, causing the patient to fear immediate dissolution. 
During the paroxysm, the pulse is feeble and irregular, the 
face pale, and covered with a cold sweat, and the patient ap- 
pears as if in a fit of apoplexy, without the power of sense oi 
motion. The disease makes occasional attacks, at longer of 
shorter intervals, for years, and at last suddenly puts a period 
to the patient's life. 

This affection appears to be of a spasmodic or convulsive 
nature, as is shown by the manner of treatment, which is m3st 



Diseases of the Heart, 347 

successful. It is f}und to attack chiefly those who are of the 
make which has beer supposed most liable to apoplexy, viz., 
those with large heads and short necks, and who lead a seden 
tary, luxurious and inactive life, who are disposed to be cor- 
pulent, and especially such as are of a gouty habit. It seldom 
attacks persons under fifty years of age. 

Our treatment should consist in preventing, as well as cur- 
Ug, by diminishing the quantity of blood in the system, by 
purgatives sufficient to keep the bowels open, spare diet, and 
avoiding everything that would quicken the circulation. 
During the paroxysm, stimulants must be very cautiously em 
ployed ; the head and temples are to be bathed with cold 
water and vinegar ; a slight bleeding may be necessary to 
relieve the overloaded heart, gentle pressure should also be 
employed on the left side, to empty the heart / mustard should 
be applied to the extremities, and on the appearance of re- 
turning breathing, hartshorn is to be applied to the nose at 
intervals. The disease has been mitigated by forming issues 
in some part of the body. Also by blisters, or tartar emetic 
ointment applied to the chest. Mustard to the ankles, and 
active purgatives, are almost always beneficial. 

Persons who are subject to this disease should be careful to 
shun all mental irritation, and every outburst of passion or ex- 
citement that would hurry the circulation. Moderate exercise 
should be daily taken in the open air, but no violent exertion 
indulged in ; and all attempts at going up a rising ground 
should be avoided, or if made, should be with the utmost care. 
The food should be plain, moderate in quantity, and easily 
digestible ; such as is not liable to occasion flatulence. Fer- 
mented and distilled liquors are altogether improper. On any 
appearance of fullness of blood, animal food should be entirely 
abandoned, and mild purgatives (epsom salts, rhubarb, castor 
oil, rochelle salts, &c.) frequently taken. A perpetual blister 
or other irritation in the region of the heart is sometimes use- 
ful, and warm bathing to the feet and legs will help still fur- 
ther to prevent the undue flow of blood to the other parts of 
the body. Mustard or cayenne pepper in the warm water, 
wil render the bath more stimulating and of greater service. 

DISEASES OF THE HEART. 

OwiNGt to the use of tobacco and intoxicatiug drinks, which 
prevail to such a fearful extent at the present day, diseases of 
the heart are greatly on the increase. Each issue of the 
morning paper, almost, records the " sudden death" of some 
loved one, who has left home and friends in apparent good 



3i8 Diseases of the Heart. 

health " in the morning," but is brought home cold in the em 
brace of death. What a pity that intelligent beings should 
use such deadly poisons ! However, diseases of the heart are 
brought about by other causes ; still, where there is any ten- 
dancy to the disease, or it naturally exists, though unknown 
to the individual, rum and tobacco render it doubly dan 
gerous. 

If from any cause one or more of the valves. of the heart 
should become deficient, it is evident that each time they close, 
a small portion of blood will pass back, or " regurgitate," intc 
the heart — and this actually occurs in cases of disease. And 
the consequence of the long-continued and constantly-repeated 
disordered action is to cause stretching, or " dilatation," of the 
cavity which receives the regurgitated blcod. This one in- 
stance will explain how one slight derangement in the nicely- 
balanced machinery of this important organ gives rise to 
another. From somewhat analogous causes, the blood may 
regurgitate into, or be dammed up in the lungs, or in other 
parts of the body, causing hemorrhage, dropsy, &c. 

Sometimes there may be impediments to the circulation ; 
the valves above alluded to, or others, may not yield as they 
should do, or there may be other causes which render it diffi- 
cult for the heart to propel the blood through the body. In 
such a case, the heart, like any other muscle under similar cir 
cumstances, acquires increase of substance, in consequence of 
the continued increased exertion demanded of it, to maintain 
the proper circulation ; and thus we have a cause and effect, 
producing enlargement of the heart — an evil certainly, but a 
lesser evil to prevent a greater, for in this very enlargement — 
this strengthening, as it were, of the heart to do its extra work 
— the patient's safety lies. 

Of course there are many other forms of heart disease, but 
the above instances will convey some rational idea of the na- 
ture and peculiarities of the disorders of the organ in general. 
It would be quite profitless in this work to enter into anything 
like detail respecting diseases of the heart or irlieir treatment; 
disorders so varied in their nature and symptoms, can only be 
properly investigated and managed by a medical man, con- 
versant with the mechanism and the functions of the humaa 
frame at large, and in their relations of mutual dependence. 

Affections of the heart are manifested by paic in the chest 
difficult breathing, cough, palpitation &c. ; and at other time 
by fain tings, giddiness, irregular pulse, &c. ; but there is not 
one of these symptoms, or any combination of them, which 
may not be \eveloped under certain bodily conditions, al 



Diseases of the Heart 349 

though the heart is perfectly sound. None, therefore, need 
alarm themselves merely because such symptoms occur ; they 
happen at times more or less to all ; still they ought not to be 
neglected ; if they continue to recur, a medical man should be 
consulted. If there is no disease the mind is set at rest, and 
any general disorder which may have caused the symptoms 
will probably be rectified. The above cautions are given, 
because there is no class of diseases of which people are so apt 
to fancy themselves the subjects as those of the heart ; and the 
more they think of the symptoms, the more likely are they to 
continue or increase, from an organ so intimately connected 
with the emotions of the mind as the heart. Even if the heart 
be unaffected, it is by no means advisable to permit it to con- 
tinue to be functionally disordered, (irregular in its actions,) 
either by mental emotion or by sympathy with other organs, 
for the functional disorder may end in organic disease ; that it 
does so sometimes is evident from the fact that there is no 
more fertile source of heart disease than those convulsions, 
either commercial or political, which occasionally agitate so- 
ciety. 

When disease of the heart, either insipient or confirmed! 
does exist, it cannot too soon be discovered by examination 
nor the necessary precautions and regulated mode of life toe 
Boon adopted ; for with these precautions, a large majority of 
persons who are the subjects of heart affection may not only 
continue to live for years, sometimes many years, but to enjoy 
life. True, the knowledge to any one that he is himself the 
subject of heart disease may be uncomfortable, but it cannot 
De unprofitable. He may be aware that heart diseases are 
sometimes apt to have a sudden termination, and that his life 
may be somewhat more in jeopardy than that of an unaffected 
person ; but surely to every right-thinking man, this fact 
would rather be an argument why he should know his real 
condition. The possibility of his being called away from the 
affairs of this life without warning, should be a reason for his 
keeping them well arranged ; and still more important, should 
it be a reason that in conducting his earthly stewardship, he 
ihculd do it, not only with reference to this world, but to give 
account of it in another. And when the many chances and 
jontingencies of life are considered, the consciousness of being 
the subject of heart disease amounts to little more than such 
contingencies assuming a more prominent position in the 
mind ; and to the individual it may be a merciful dispensation 
of providence, as, being reminded more frequently of the un- 
certainty of human life, he may be constrained to look for » 



350 Diseases of tht Heart 

realization of true happiness only beyond this vale of tears,— 
the Christian's home in heaven ! 

Besides the two already mentioned, there are other causes 
of disease of the heart : mental disturbance and agitation is a 
most frequent one ; also mental depression and grief, which, 
if long continued, appear to exert much influence over the 
•rgan, and to make the phrase " a broken heart'"' not altogether 
a poetical fiction. Violent passion strongly affects the heart 
— its indulgence may lay the foundation of disease, which its 
repetition strengthens, and may bring to a fatal termination. 
Rheumatism, or rather rheumatic fever, is probably another 
of the most fertile sources of heart affection. In this disea&e, 
inflammation of some portion of the membranes covering or 
lining the heart, is apt to occur, and to be followed by sush 
effects as induce permanent change. Violent physical exer- 
tions, and dissipation of all kinds, are causes of disease of the 
heart. It has been said that persons with heart affections may 
continue to live and enjoy lite, but it must be under a more 
regulated and restricted system of living than is imperative on 

Eersons in health. Every thing which may be a cause of 
eart affection must also be a source of aggravation ; all men- 
tal or physical excitement especially so. When these aro 
guarded against, the rest may be summed up in — strict atten 
tion to the general health. Whenever an old symptom be- 
comes aggravated, or a new one, such as swelling of the legs, 
&c, appears, medical advice should always be obtained. 

Palpitation of the Heart. — This is often caused by the 
various emotions of the mind, as fear, joy, anger, or excite- 
ment of the mind from any cause. When it arises, however, 
on every trivial occasion either of mental emotion or of physi- 
cal exertion, or without occasion at all, as it often does, even 
during rest in bed, then it requires attention, not solely on 
account of the discomfort it gives rise to, but because it may 
lay the foundation of disease of the organ which is so con- 
stantly subject to over-excitement. Affections of the heart 
become more common after seasons of much public excitement 
of any idnd — an effect traceable only to the frequent dis- 
turbance of the organ by the passions or emotions of the 
mind. 

Independent of disease, palpitation of the heart is liable to 
occur in the young of both sexes, and in females particularly, 
soon after the age of puberty — in the latter being very gene 
rally associated with hysterical tendencies ; in such cases, it ii 
met with in its most aggravated forms, and often of such 
violence as to prove alarming. In any case the tendency to 



Diseases of the Heart. 351 

palpitation is more common in the nervous temperament, and 
a increased by whatever gives undue predominance to that 
temperament, such as indolence, luxurious habits, and the 
indulgence of feelings and imagination artificially excited ; 
and having once begun, it is kept up and aggravated by the 
continued attention with which the mind is apt to dwell upon 
the ailment. The individuals subject to it easily imagine 
Jheinselves as subjects of heart disease, watch every motion 
almost of the heart, and thus under the influence of their own 
imaginary fears, produce the very symptoms they dread. 

This nervous condition (for it is generally nothing else) ia 
only to be got rid of by those measures which give a more 
vigorous and healthy tone both to mind and body. The false 
excitement of imaginative literature, I mean reading trashy 
novels, etc., if it has been indulged in, must be exchanged for 
something which calls for some healthy mental interest. 
Where it can be adopted, the pursuit of some branch of natural 
history, botany, geology, or any other out-door occupation, are 
the best pursuits ; they occupy the mind, and draw it away from 
its own morbid fancies, even in the time of exercise, which ia 
rendered doubly invigorating by the mental excitement which 
accompanies it. Along with these means, a system of die£ 
calculated to give good nourishment should be adopted ; heated 
and ill-ventilated rooms, above all things, are to be avoided, 
early hours observed, and if a feather bed has been habitually 
lain upon, a firm hair or husk mattrass should be substituted. 
One article of diet requires especial mention, as being pecu- 
liarly injurious in such cases ; tea of any kind is better avoided, 
but green tea is absolute poison / coffee is scarcely allowable, 
and cocoa or milk should invariably be substituted for either 
of the above more stimulant beverages ; wine or malt liquor 
may be injurious, or the reverse, according to the previous 
habits of the patient and the nature of the case ; if depression 
or debility follow their withdrawal, the tendency to palpita- 
tion is certain to be increased. In addition to these measures, 
regulation of the bowels, the use of the shower-bath, cr better, 
of the douche, or water poured down the spine, and occasional 
mustard plasters on the chest or between the shoulders, are all 
useful, especially if, as frequently happens in cases of aggra- 
vated palpitation, any tenderness of the spine is found to exist. 
In cases of nervous palpitation, medicine is not much called 
for, unless to remedy other disorders, such as indigestion. 
Some patients derive much benefit from a teaspoonful of a mix 
ture of equal parts of tincture of valerian, tincture of henbane, 
and spirits lavender: taken twice or three times a day in water. 



352 Scurvy. 

Hartshorn in teaspoonful doses with cold water, is cften useful, 
especially if there is much flatulence ; or ether may be taken 
in ten or fifteen drop doses, either alone or with the above- 
mentioned remedies given in water. The ether, however, ia 
aiore generally serviceable as a remedy, during an attack of 
palpitation than when taken regularly. In most cases of thia 
kind it will be found necessary to change the remedies ocetr 
sionally, or they will lose their effect. 

8 CUR VY. 

By medical writers, and by well-informed non-professional 
men, the term scurvy is now applied to that disease which ia 
produced by a long abstinence from fresh vegetable food, ex- 
posure to damp, and the influence of the depressing passions, 
and which is therefore frequently observed in long voyages, 
in camps, and in besieged towns. It comes on gradually, with 
heaviness and aversion to motion, with dejection of spirits, 
anxiety, and great debility. The countenance becomes sallow 
and bloated, the breathing is easily hurried, the teeth become 
loose, the gums are spongy, and bleed when slightly touched ; 
and livid (or purple) spots appear on different parts of the 
body. A very curious circumstance sometimes occurs in 
acurvy : old wounds, which have been long healed, break out 
afresh. J?f the disease is not checked, the joints become swelled 
and stiff, the tendons (sinews) of the legs stiff* and contracted ; 
a dark colored blood issues from the nose, the eai s, and other 
parts ; offensive stools are discharged, and the patient dies with 
symptoms of diarrhoea or dysentery. 

The cause of scurvy is long confinement to a diet destitute 
of a due admixture of fresh vegetable substances. The fre- 
quent occurrence of scurvy in long voyages, during which the 
ship's crew are compelled to live much on salt provisions, and 
in besieged towns, where the provisions are scantyand bad, and 
in cold, damp and poor situations, where human life is with 
difficulty supported, is thus accounted for. Among oth?r very 
exciting causes, we are to reckon want of cleanliness and ven* 
tilation, a damp and cold atmosphere, and, above all, depress- 
ing passions. It has been ascertained that by keeping the ship 
perfectly clean and dry, by allowing the men as much recrea- 
tion and exercise as possible, and by taking to sea a proper 
aupply of lime or lemon juice, and distributing to the shi] s com 

Eany a portion of it every day, when their fresh provisiima 
egin to fail, they may be kept from scurvy as effectually aa 
any number of persons living on shore, and using fresh veg- 
etables every day. This has, for a considerable number o/ 



Scwvy. 353 

y%»rg, been ascertained on a very extensive scale of expe 
rience. From one to two ounces a day are a sufficient quantity 
for this salutary purpose ; and it may be given diluted wito 
water, or made into lemonade, with sugar and water, so as to 
form a healthful and refreshing beverage. When in any indi- 
viduals the tendency to scurvy appears stronger than in others, 
as indicated by the spongy and easy bleeding gums, by stiff- 
ness of the hamstring, by inertness and dejection of spirits, it 
will be proper to give an ounce of the juice three or four time* 
a day till the tendency is diminished. Lime juice is apt to 
ferment, and not to keep properly, owing to the quantity of 
pulp and mucilage squeezed out along with it. To prevent this 
fermentation, it is proper to mix with it a little alcohol or 
carbonate of lime. It has been ascertained by experiment that 
the curative properties of the lemon juice depends very much 
Da the potash which exists in combination with the acid. So 
that cream tartar and the carbonate of potash given in small 
4nd repeated doses, say one teaspoonful three times a day in 
% glass of water, will act well where the lemon juice can not 
be had. And so far as our experience goes, the same powerful 
yet simple agent which prevents scurvy, is also fully sufficient 
to cure it. When circumstances admit of it, and we are able 
to procure for a ship's company an abundant supply of fresh 
cieat and vegetables, this is the natural and appropriate remedy ; 
but in the last stages of the disease, when the debility is great, 
it is a matter of much danger to take the sick on shore, as they 
not unfrequently die in the boat that carries them thither ; 
and instances have even occurred of the land air being too 
oppressive for the lungs of those, who did not previously show 
marks of so great feebleness. It is by far the safest way to 
attempt the cure of the men on hoard their ships ; and when 
the disease abates a little, and the strength is beginning to 
return, it may then be accelerated by a removal on shore, and 
by the usual diet and exercise to be found there. Many aux- 
iliary circumstances are to be called into action, both in the 
cure and prevention of scurvy ; the greatest attention to ven- 
tilation and cleanliness, frequently washing the ship in fine 
weather, fumigation between decks by the vapors of the nitric 
or muriatic acid, by pouring either of them over a small 
quantity of common brown sugar, or pieces of zinc, iron, etc. 
attention to increase the real comfort of the men, and to 
check all intemperance; to promote regularity of discipline 
and cheerfulness of mind. Various articles are to be used in 
diet which counteract the pernicious tendency of a long 
continued use of salt provisions, as spruce or treacle beer 



354 Consumption. 

•ourcrout, preparations of oatmeal, and occasion all y parboiled 
fresh vegetables, such as water cresses, radishes, scurvy grass, 
lettuce and the like, which may be eaten raw ; or cabbage, 
turnips, spinage, cauliflowers, boiled ; or ripe fruits, as oranges, 
melons, pine-app.es, plantain, etc. 

CONSUMPTION. 

This disease has been truly termed the " great destroyer of 
our race." It enters the cottage and the castle ; it kills tht 
rich and the poor, the old and the young, and regards not sex 
or condition, but rushes on, slaying its tens of thousands every 
year. Consumption is only a, portion, strictly speaking, of a 
constitutional malady which very frequently develops its in- 
tensity in the organs of respiration, (the lungs), but may do so 
in other modes and in other organs of the body. Its constitu- 
tional nature requires to be impressed upon the mind of people 
in general ; for, regarded only as a disease of the lungs, alarm 
is not taken, nor are remedies generally resorted to until its 
effects upon these organs become manifest; the antecedent 
period in which the constitution is giving way is overlooked, 
and that time is lost in which the first indications of disease 
might have been successfully attended to. 

We may state that the causes of pulmonary consumption 
fc.*-e all those which occasion debility generally, not excepting 
the most frequent of all, hereditary predisposition, or that 
tendency to the disease which exists so strongly in some 
families, that no care or precaution can ward it off, nor pre- 
vent it seizing in succession member after member of a house- 
hold. Fortunately, this intensity of hereditary transmission is 
not so very frequent, but there are few families in which the 
tendency does not more or less exist ; there are few which can- 
not number amid their deceased relatives some victim of con- 
sumption With a susceptibility so widely diffused, it becomes 
a serious 3onsideration with all by what this tendency is en- 
couraged, and how it may be diminished. The first considera- 
tion that presents is marriage. There can be no question, that 
frcm errors in the contraction of this great engagement of 
life, xauch of the hereditary tendency to consumption is de- 
veloped, and especially when the union is between parties 
nearly related by blood ; doubly so if the predisposition already 
exists in the family. Delicacy or debility of either parent, 
particularly of the father, is very apt to entail consumptive 
tendencies upon the children ; and the same follows if the 
parents are either too young, or if the father be advanced in 
Jtfe. The mistake is a very common one, that marriage and 



Consumption. 355 

child-bearing act as a check upon tlie progress of consump- 
tion, and the step is often advised even to the comparatively 
young with this view. The error is a serious one ; nothing can 
be more trying even to a healthy female than having a family 
before the constitution is formed ; and most certainly it is so to 
the weak. It is true, apparent temporary amendment of con- 
sumptive symptoms sometimes occurs, but the powers of life 
are sapped by the too early call on their exertions. 

Great care is required near the approach of the age of 
puberty, especially in the case of those who have displayed 
any scrofulous or consumptive tendency. The development 
of the body which is going on requires a full supply of the 
most nutritious food, animal food particularly. The secre- 
tions should, if possible, be kept in healthy activity, and, more 
especially, all sources of exhaustion most strictly avoided. 
Youths especially must be warned against the evil of prolonged 
physical exertion / and not less so against the mental efforts, 
which those especially, who partake of the nervous and exci- 
table constitution of the hereditary consumptive, are apt to 
give way to, in competitions at school or college. 

Along with the consumptive tendency, two very different 
conditions of physical development are found. In the one, 
there is the fair fine skin and bright red complexion, the fair 
hair, the light eye, with its pearly looking white, and the 
tapering fingers ; in the other, the dark hair and skin, the 
latter almost dirty-looking, and the swollen-looking upper lip. 
Consumption varies much in its initiatory stage ; sometimes it 
steals upon the patient most slowly and imperceptibly ; at 
others, developed probably by some acute attack, it appears 
to start at once into activity. Generally, for a considerable 
period before marked symptoms — or at least symptoms which 
attract general attention — show themselves, the person has felt 
weak, languid, and complained much of cold, probably has 
sunk in flesh, and a short dry cough has come on, apparently 
without cause, or there has been continued dyspepsia. If the 
patient is a female, the monthly discharge has become irre- 
gular, or stopped. It may be that these symptoms have been 
aggravated during winter, and disappeared partially or en- 
tirely with the advent of warm weather. Such symptoms may 
go on for a longer or shorter period, ebbing and flowing, but 
still gaining ground, or they may progress more unremittingly, 
though still slowly, or become suddenly aggravated by taking 
cold, some unusual fatigue, or the like. The emaciation be- 
comes too evident to escape notice, the cough is unabated and 
becomes troublesome, the voice assumes a peculiar hollow 



356 Consumption. 

found, the breathing is quickened, and it may be that spitting 
of blood, profuse night perspirations, or even diarrhoea, hare 
set in before the patient's condition excites either alarm in 
their own mind or in that of their friends. Indeed it very 
frequently happens that the patient is the last to take the 
alarm, the last to entertain the idea of the fatality of the dis- 
ease, of which this hopefulness of recovery is a well-marked 
•ymptom. 

As regards the prospect of recovery from consumption— for 
recovery does undoubtedly take place — much depends upon 
the original and existing constitution and the habits, past or 
present, of the individual, and the worldly means within his 
power. 

When once the disease has become established in an indi- 
vidual of strong hereditary tendency to it, or in one who hr.g 
broken down his constitution by dissipation or intemperance, 
or who is the subject of some other debilitating disease, hope 
9f amendment can be but small. If, on the contrary, the affec- 
tion is more probably induced, and rather accidental than the 
result of original constitutional tendency, the probability is 
that under proper management, and with the aid of the gre it 
curative powers of cod-liver oil, and medicated inhalation, (s« e 
Catarrh in the Head in another part of this work) not on! y 
amendment, but permanent recovery may be obtained. Whc n 
consumption has advanced beyond its first stage, all thesymp- 
toms already mentioned are increased, the cough and perspirt* 
tion particularly become more distressing, and the tendency 
to diarrhoea, (frequently with severe spasmodic pain in the 
bowels,) notably increased; expectoration is often difficult, 
either from weakness or from the thick matter expectorated ; 
the hair falls off, and emaciation continues. 

The prevention of so fatal a disease as consumption is a more 
important subject in a work like the present, than its treat- 
ment ; and in those predisposed, the preventive or " prophy- 
lactic " system must be continued life through, even into old 
age. It is a popular error, that by the time middle life is 
reached the liability to consumption is over. Such is not the 
case, for even the u three score and ten " is sometimes termin- 
ated by the disease. 

In any condition of life, the question of tendency or not to 
consumptive disease should influence the choice of field for 
exertion, and not only of field, but also of the nature of the 
business of life. Any occupation which renders the inhalation 
of irritating substances unavoidable, is to be avoided by the 
consumptively inclined man; and not less so, that wbicii 



Consumption. 357 

inrolvea confinement n a constrained position or in a clost 
room. 

The most eligible employments are those which require 
muscular exertion of not too exhausting a kind, and without too 
great exposure to the weather ; the gardener, the carpenter, 
butcher, the farm-servant, are all less likely to be the victims 
of the disease. In whatever situation or grade of life, however, 
a person may be placed who is predisposed to consumption, 
much may be done to keep up the powers of resistance by 
keeping up the general health to the highest possible stand- 
ard, by diet, early hours, attention to the skin, etc. (See " How 
to preserve Health" in the first part of this work.) 

The chest and shoulders should be bathed every morning 
with, cold salt water, and rubbed afterward to promote reaction. 
Cheerfulness of mind and moderate mental exertion are im- 
portant, while perfect temperance in the use of alcoholic 
stimuli is indispensable ; but any change to their total disuse 
cannot be made suddenly, if the patient has been accustomed 
thereto without danger. All the usual sources from which 
"cold is taken" are to be shunned, particularly wet feet, 
sitting in damp clothes, crowded ball-rooms, and public assem- 
blies ; and, lastly, when exposure to cold air, especially to east 
winds, or to the foggy atmosphere of night, is unavoidable, 
the protection of a respirator to go over the mouth and nos- 
trils — a silk handkerchief being about the handiest — should 
be resorted to. 

Medical men are often asked their opinion as to the commu- 
nicability of consumption from one person to another. That 
it is not generally communicable is certain ; that it has been 
thought to be so under circumstances of predisposition, and 
when there has been close communication between two per- 
sons, should be sufficient to caution other members of a con- 
sumptive family from hanging too much over one affected with 
the disease ; and certainl' in any case forbid the occupation 
qf the same bed. 



358 Dyspepsia , or Indigestion. 

BYSFEJ? SIA or INDIGESTION. 

This distressing complaint has been said truly to be " nc 
respecter of persons ; "its symptoms are usually well known; 
it originates or is bronglit about by a great variety of causes ; 
among which it is often found associated with a diseased state 
of the liver. Persons who have used spirits of any kind to 
e&cess, or stimulants of any description; such as spices or 
highly seasoned food, and those also who have used tobacco to 
great excess, by which thet?oats and functions of the stomach 
have been impaired and debilitated, are liable to indigestion. 
A costive habit, acquired by permitting the bowels to remain 
too long without evacuation, will bring on this disease, and 
persons who are long confined to any stationary or sedentary 
business, without taking the necessary exercise, are often subject 
to it. When the complaint is firmly seated in the stomach, it is 
marked by belchings of wind, gnawing and disagreeable sen- 
sations at the pit of the stomach, risings of sour and bitter 
acid into the throat, occasioned by the food not being properly 
digested ; great irregularity of appetite, which is sometimes 
voracious and at other times greatly deficient, and a sinking 
and oppressive debility or weakness of the stomach. In 
addition to these symptoms of indigestion, on gratifying the 
appetite at any time, the stomach in a short time afterwards 
becomes oppressed with sensations of weight and fullness, the 
head becomes confused, the sleep very much disturbed, the 
bowels very irregular and costive, the urine high-colored, and 
the poor victim commences taking medicines for relief, and 
brooding in dejected silence over thousands of unhappy retro- 
spections of his past life, and countless melancholy anticipa- 
tions of the future. 

Should disease of the liver be connected with this disease, a 
dead^and heavy pain will be felt in the right side ; the water 
deposited in the chamber will have, on cooling and settling; 
a brick-dust colored sediment, which, if permitted to remain 
any length of time, will adhere in rings of a reddish hue to 
the inner sides of the urinal ; a pain will be felt in the top 
of the shoulder and back of the neck ; the feet and hands will 
frequently become benumbed, or what is called " getting to 
aleep," from want of regular circulation ; the complexion wil3 
become of a yellowish hue or tinge, and general uneasiness oi 
the whole system will be felt. 

The treatment of this disease consists in keeping the bowels 
open regularly. If they are not rendered so by the use of 
•tewed fruit and ripe fruit uncooked, with injections of half 
pint of cold water up the bowels every morning, a dose of 



Heartburn,) or Sourness of the Stomach. 359 

•ome mild purgative medicine should be taken. (See " Medi* 
tines, their doses and uses") so that the bowels are opened 
every day. Friction and percussion, by striking with the 
open hand, gently over the region of the stomach for a few 
minutes, half an hour before each meal, should be attended to, 
and be sure to never eat as much as the stomach seems to crave, 
that is, always " get up hungry" and never eat any article of 
food known to disagree with the stomach. Eat slow and an 
regular hours. Avoid the use of intoxicating drinks, and do 
not eat meats for supper ; sleep on a hard bed and take a 
eponps bath every morning, followed by the use of a dry, 
rougn towel and the flesh-brush ; take plenty of active out- 
door exercise, and partake of a mixed diet / and above all 
avoid the poison called tobacco, in every form. 

HEARTBURN, or SOURNESS OF THE STOMACH. 

Heaktbcrn is found to exist under very different conditions 
of the gystem. It is prevalent, frequently, with females, 
during pregnancy, the causes of which were explained under 
the head ot " Pregnancy and its Diseases." It is also of the 
greatest consequence to the dyspeptic ; and may be caused by 
any thing which interrupts the process of digestion, especially 
costiveness of the bowels. The symptoms of this disease con- 
sist of a burning sensation, felt either at the pit of the stomach 
or top of the throat, and occasioned by undue acidity, or by 
irritating substances in the stomach. It is generally relieved 
by soda, magnesia, or chalk, ten grains in a little water, or 
twenty drops of hartshorn in a wineglassful of cold water — 
which neutralizes the acid. It is not, however, advisable to 
have too frequent recurrence to these palliative remedies, for 
they are only palliatives, — they cannot be taken habitually 
without weakening, not only the stomach, but the system gen- 
erally. Heartburn cannot continue to recur without there 
oeing an error somewhere ; either the diet is badly regulated, 
or the digestive organs require something more than simple 
neutralization of the superabundant acid. This acid is a badly- 
formed gastric juice, and if ii is neutralized, whatever diges- 
tive power it might possess is destroyed ; consequently the 
Btomach is called upon to secrete another supply before the 
food can be digested — a call upon its powers which cannot 
fail to be injurious. Moreover, persons finding how quickly 
a dose of alkaline medicine removes the uncomfortable »en- 
lation ot heartburn, are very apt to trust to the palliative, and 
continue their indulgences, rather than to practice the s*l$ 
denial requisite to effect a cure of the cause. 



360 Waterhrash — Jaundice. 

Prevention, therefore, or removal of tho cause, is what is of 
most importance in this disease. The bowels must be kepi 
open by mild purgatives, so that there is an operation regu 
iarly every day. Every tiling known to disagree with the 
stomach must be avoided, exercise taken in the open air, and 
all the means pointed out under the head of " How to preserve 
Health," strictly adhered to. 

WATEBBBASH, 

Medical men have strange names for diseases, as well an 
those who are not medical men. Pyrosis is the medical name 
for this disease, but usually called Waterhrash. It is a pe- 
culiar affection of the stomach, in which the patient brings up 
frequently a considerable quantity of thin watery liquid, some- 
times insipid, at others intensely acid. Before the fluid is 
brought up, often there is more or less pain experienced at the 
pit of the stomach. This complaint attacks, mostly, persons 
past the middle age, particularly females, and the fit comes on 
generally in the morning and afternoon. It usually begins 
with a severe pain in the pit of the stomach, attended with a 
feeling of constriction, or oppression, and soon after a quantity 
of thin watery fluid is thrown up, which is sometimes insipid, 
at other times it has a highly acid or burning taste. The 
causes of this complaint are various, but whatever disorders 
the stomach may give rise to it. It appears to be owing to a 
peculiar state of irritation of the stomach ; and is most cer- 
tainly relieved by the use of the white oxyde of bismuth, from 
two to three grains made into pills with extract of gentian, 
three times a day. This medicine will often perfectly cure 
waterorash / but attention to the diet, as laid down under dys- 
pepsia, is of much consequence, and will be absolutely neces- 
sary in order to render the cure permanent. A diet of plain 
animal food may be allowed, with which may be united the 
use of biscuits, home-made bread, and preparations of rice and 
milk. Daily exercise must also be taken, and frictions, with 
the flesh-brush, over the region of the stomach and bowels, 
are of no small service. The bowels must of course be kept 
open by purgatives, when necessary, even wL an making use 
©i other curative means 

J A UNDIC E. 

This disease is often improperly called "jar ders :" it is cba 
racterized by yellowness of the eyes and skin, whitish or eiajr- 
colored stools, and saffron-colored urine, which communicate! 
to substances immersed in it a saifron dye. Jaundice is cpus 



Jaundice. 361 

*d by the duet or tube leading from the gall-bladder to the 
itomach, becoming stopped up, — that is, something in the first 
place stops the flow of b*le from the liver ; and jaundice, which 
consists in an absorption of bile into the blood, is the result. 
Probably, gall-stones, or thickened bile, are the most com- 
mon obstructions ; but tumors which press upon the duct, or 
spasm, may also stop the bile and induce jaundice. Jaundice 
has sometimes been caused by violent mental emotions, (un- 
easiness of mind, from various causes,) also, an irregular or 
sedentary mode of living will produce it as well as intemper- 
ance, especially continued indulgence in spirituous liquors. 
The presence of bile in the blood is quickly manifested by the 
color of the skin, and also more particularly of the white of 
the eye ; the shade of color varying from the slightest percep- 
tible tinge, to deep golden yellow, or even brown. At the 
same time, the stools become white and chalky-looking, and 
the urine — sometimes the perspiration — is deeply tinged with 
bile ; the constitutional symptoms are generally those of dis- 
ordered digestion, (see Dyspepsia?) headache, languor, &c. 

The principal objects of treatment are, to allay irritation in 
the stomach and bowels, and to remove the obstruction exist- 
ing to the free passage of the bile, through the biliary ducts, 
and along the bowels. It will be frequently found, that the 
best means of allaying irritation in these parts will be the 
most effectual in removing the jaundice. In the young and 
robust, bleeding by leeches applied over the region of the liver, 
will often be demanded, especially in recent cases ; cupping 
over the stomach and region of the liver is generally an im- 
portant remedy. 

The patient should also take a warm bath at ninety-six or 
seven degrees, eyery other morning about eleven o'clock, with 
the following pills during the day : Castile soap, a drachm and 
a half ; rhubarb, in powder, eight grains ; ipecac, in powder, 
ten grains ; oil of juniper, ten drops ; syrup of orange peel or 
lemon, a sufficient quantity to make the whole into twenty- 
four pills. Three to be taken twice or three times a day. Or 
when there is a good deal of pain in the bowels, the following 
may be used instead : compound extract of colocynth, and 
extract of henbane, of each, a drachm ; divide into twenty- 
four pills ; one, two, or three to be taken as above directed. 

Gentle purging is perhaps the most beneficial mode in most 
of cases one or two tablespoonfuls of both the Epsom and 
Glauber's salt may be dissolved in half a pint of lukewarm 
water, and taken every morning for a fortnight ; and resumed 
for another fortnight or three weeks after being laid aside fo* 
a week. 



362 Milk Sickness— Colic. 

If there is much pain in the affected side, mustard plastcn 
or poultices, applied frequently, will be of much service. 
Sometimes giving an emetic of ipecac will cause the gall-stem 
or thick bile to pass into the stomach, and thus relieve th«s 
difficulty at once. 

Many persons who have resided long in a hot climate, con 
tract a sallow, yellowish complexion, which hue often pervade* 
the whole skin ; this is generally regarded as a mild sort of 
jaundice, or as arising from the absorption of the bile, but it 
is usually of a different nature. In most instances, it is not 
owing to this cause, but to a peculiar alteration in the circu- 
lation, on the external surface of the body, in consequence of 
the skin's sympathizing with a weakened and irritated con- 
dition of the digestive organs, more especially of the stomach 
and bowels. 

MILK SICKNESS. 

This is a peculiar affection which occurs in many of the 
Southern and Western States, in the autumn. It has been 
called by various names, such as " swamp sickness," " tires," 
" slows," " stiff joints," " river sickness," " puking fever," &c. 
It affects both the cattle that eat of the herb which causes the 
disease, and also the persons who use the milk taken from the 
cow, or who eat the flesh of animals affected with the dis- 
ease. 

It has not as yet been satisfactorily settled what kind of an 
herb or plant causes this sickness ; however, the symptom! 
show it to be a narcotic, or poison. There is vomiting, purg- 
ing, extreme nervous agitation, great prostration, trembling, 
&c. The treatment consists in giving plenty of warm sweet- 
ened water every few minutes, until the stomach has been 
emptied by vomiting ; then a mustard plaster over the stom- 
ach and bowels, and injections up the bowels of lukewarm 
water, until the bowels operate, after which a mild purge of 
castor oil. The patient must be kept perfectly quiet in bed ; 
should symptoms of sinking show themselves, give stimulantg 
— brandy, whisky, wine, hartshorn, or whatever is handy 
To allay the thirst, give strong coffee (cold) without sugar 01 
milk. 

COLIC 

This disease is produced by so many different causes, is so 
varied in its symptoms, under different circumstances, and re- 
quiring treatment suited to its different causes and symptoms, 
tnat we have thought it best to treat it under <he following 
divisions : 

Colic from Indigestion. — Among the most common symp- 
toms occasioned by an excess in eating, whereby the stomach 



CoUc. 363 

■ leaded beyond what is compatible with the regular and 
healthy performance of its functions, is a violent pain or colic, 
accompanied with nausea, headache, and dizziness, preceding 
fcne ejection of the contents of the stomach by vomiting; and 
terminating subsequently in a griping looseness of the bowels. 
But it is net only by excess of food that this species of colio 
is produced; it is occasioned also by the quality of the food* 
various hi^h -seasoned and made dishes ; certain articles of a 
highly indigestible nature ; malt liquors ; cider and wines of a 
bad quality ; the stones, kernels, husks and enveloping mem- 
brane of various fruits, swallowed when the latter have been 
eaten, &c, frequently give rise to it. We find it, however, in 
many instances originating after meals, from causes more 
obscure, and accompanied by various additional symptoms of 
a much more violent and distressing nature, as though the food 
itself had proved poisonous, or some poisonous substance had 
been intermixed with it. Occasionally these additional symp- 
toms consist of an intolerable feeling of suffocation ; a feeling 
of constriction in the throat ; the face and eyes become swol- 
len ; with excessive thirst ; a burning heat over the whole 
surface ; a feeling of itching or prickling in the skin, and an 
eruption, sometimes in the form of minute raised points, at 
others in that of larger elevations ; the skin peeling off on the 
iubsidence of the attack : in addition to which we sometimes 
have a species of delirium, with twitching of the muscles. At 
other times the symptoms consist of great anxiety ; difficulty 
of breathing ; dejection of spirits ; spasms of the linrbs, as well 
as of the bowels and muscles of the abdomen ; coldness of the 
extremities ; loss of sight and hearing ; convulsions, &c. 

The first of these two last varieties of colic from indigestion 
arises in general from a peculiarity of the individual, the con- 
dition of the stomach at the time of eating, or from some pecu- 
liar principle connected with animal food of a particular 
description. 

The articles of animal food which in general give rise to 
the species of colic under consideration, are various shell-fish, 
mussels, crabs, lobsters, &c. 

Animal substances, in the process of cooking, or in the dif- 
ferent processes to which they are subjected with the view of 
preserving them for future use, or from their being improperly 
?r too Img kept, may undergo a change, rendering them 



in> 



proper articles of food. 

The second variety mentioned of the colic from indigestion, 
ii produced generally by eating deleterious vegetable sub* 
itances, eitker mixed with our food or eaten in mistake fof 
healthy articles. 



364 Colic. 

The treatment in all the varieties of this species of col»c If 
to be commenced with an emetic, in order to unload tb* 
stomach of the offending matter. Where the disease has been 
induced merely by a surfeit, or by too rich food, a dose of 
ipecac will be proper ; in some cases, even warm water wilj 
be sufficient ; but in the two other varieties, a more prompt 
and powerful emetic is demanded, and it has been recom- 
mended to prescribe immediately a full dose of the sulphate of 
line (twenty grains, in a gill of warm water.) The emetic if 
to be followed by a brisk purge, which may be aided in itf 
operation by injections up the bowels. In the second variety, 
the vital powers of the system are in general rapidly, and to a 
most alarming extent, exhausted ; it therefore becomes neces- 
sary, as soon as possible after the evacuation of the stomach 
to rouse the system, by the administration of the most diffusible 
stimulants and cordials, such as sulphuric ether, ginger tea or 
cayenne pepper tea ; and vinegar, diluted with water anc 
sweetened, should be drank in abundance. These remedies 
may be aided by stimulant applications to the extremities, 
and all the other means of rousing the vital powers from their 
state of exhaustion. In the second variety, the treatment dif- 
fers but little from that already laid down. The great indica- 
tion is to get rid of the offensive matter as quickly as possible, 
by active emetics and purgatives ; afterwards to rouse the 
system by external stimulants, mustard, friction, &c. ; and to 
subdue the irritation and general convulsions by opiates. A 
mixture of ether and laudanum, ten drops of each, in water, 
is an excellent internal remedy ; and in many cases, much 
advantage will be derived from the plentiful use of water and 
vinegar, sweetened with sugar. 

Flatulent Colic. — In addition to the general symptoms of 
colic, in this species we meet with a considerable and unequal 
distension of the abdomen, occurring suddenly. There is a 
rumbling of wind in the bowels, and a frequent expulsion of 
it both up and down. These discharges of wind in general 
occasion some relief to the patient, and the pain is also dimin- 
ished by pressure upon the abdomen, bending the body for- 
ward, &c. Flatulent colic is produced by every thing which 
occasions derangement in the stomach and bowels, and it ig 
frequently complicated with dyspepsia. In many cases of the 
disease, the affection appears to be induced by a morbid pro- 
duction of air by the bowels themselves, but in general it ii 
dependent upon the use of fermentable substances as article* 
of diet, particularly vegetables. The fruits of the season, 
cabbage, beans and peas, new cider, wines, beer and porter, 
honey, onions, various kinds ot nuts, &c, &c, being introduced 



Colic. 365 

mto tlie stomach when that organ is in a state of debility 
frequently undergo a rapid fermentation, and give rise to an 
enormous development of gas, producing the symptoms pecu- 
liar to this species of colic. 

in the flatulent form of colic, our indications are to relieve 
the spasm, exp~l the wind distending the bowels, and after- 
wards, by a proper regulation of the diet and the judicioui 
administration of tonic remedies, to restore the healthy action 
ef the stomach and bowels. Immediately upon an attack of 
flatulent colic, if we are convinced that no degree of inflam 
mation exists in any portion of the bowels, we should admin- 
ister ten drops of laudanum in combination with some aromatic 
or diffusible stimulant; (strong essence of peppermint being 
about the best, ten to twenty drops,) and at the same time 
apply mustard plasters or stimulating fomentations externally 
to the abdomen. Yinegar and hops will be found very gooa, 
or large bran poultices, frequently renewed, will answer. The 
best internal remedy is probably a combination of ether and 
taudanum, in proportions suited to the age of the patient and 
the violence of the case, exhibited in a draught of aniseed 01 
mint water, or the compound tincture of lavender ; at the same 
time we may administer injections, composed of some aromatic, 
a little cinnamon tea, mixed with soap suds may answer, 
but the one most to be depended on, is composed of a teaspoon- 
fnl or two of turpentine and a sufficient quantity of pepper- 
mint rubbed up with a proper portion of some thin mucilage, 
or thin gruel ; tincture of assafoetida and laudanum, ten to 
twenty drops of each ; assafoetida, a few drops in gruel, has 
also been recommended, in the form of injection. In many 
cases, hartshorn, in doses of twenty drops in water every half 
hour, will give prompt relief. After the pain has somewhat 
subsided, it will be proper to administer an active but mild 
purgative ; the best is probably magnesia, combined with calo- 
mel, to which should be added a few drops of essence of pep- 
permint. 

There is another form of colic caused by costiveness. The 
disease will be known by the fact that nothing in the way of 
diet having been taken to produce the symptoms, and is more 
gradual in its attack ; a feeling of uncomfortable fullness in 
the bowels being felt for some days before the attack ; also lose 
of appetite, headache, restlessness, &c. The treatment musl 
consist of giving an emetic, injections of soap suds up the 
bowels, and a brisk purgative and mustard plasters to the 
bowels, until relief is obtained, then being careful afterward* 
to keep the bowels regular. {See Costiveness.) 



366 Cdk. 

Bilious Colic. — This form of the disease is marked by u 
violent and intolerable pain of the bowels, which in some case* 
•eem to be, as it were, tied together, and in others closely 
puckered up, and with a sensation as though they were bored 
through with a sharp pointed instrument ; the pain occasionally 
abates, but quickly returns. In the beginning, the pain is not 
fixed to one particular spot, as it is in the progress of the dis- 
order, while vomiting also is less frequent, and the boweli 
more easily yield to the action of purgatives ; but, as the pain 
increases, it becomes obstinately fixed to one place. Frequent 
vomiting succeeds ; the bowels become more and more costive, 
until at length the symptoms, rapidly increasing in violence, 
unless the patient be speedily relieved, a total inversion of the 
action of the bowels takes place. Every thing administered 
by the mouth, or injected into the bowels, is then thrown up 
violently by vomiting; the matters discharged from the 
stomach are various in appearance ; sometimes of a green, 
yellow or dark color. 

In this disease there is violent irritation of the bowels, in 
consequence of which they are thrown into a state of spasmo- 
dic contraction, by the vitiated secretions poured into them 
from the liver and surrounding glands. 

Though this is a formidable disease, if taken in time it can 
>e successfully treated in most of cases. 

In every case where the symptoms are of any considerable 
fiolence, particularly if the patient be of a robust habit, it will 
6e proper to commence the treatment of bilious colic by apply- 
ing leeches to the bowels, and afterwards a warm poultice to 
encourage the bleeding from the parts ; or if leeches are not 
handy, scarifying, and the application of cups will be advisable; 

Immediately after the leeches, or cupping, ten grains of calo- 
mel and one of opium in combination, should be administered 
by the mouth, and the patient may at the same time be im- 
mersed in a warm bath ; or if this be not practicable, warm 
fomentations of hops and vinegar, should be applied over the 
whole of the abdomen, and continued for some length of 
dme. 

If, after a reasonable time (two or three hours), the patient if 
not better, the calomel and opium should be repeated. This will 
usually relax the spasm of the bowels, and at the same timeexcitf 
4he healthy action of the liver, and unload the bowels of the 
diseased secretions by which the irritation is kept up Thf 
action of the calomel may be assisted b} r injections of a laxa- 
tive nature thrown into the bowels, and frequently repeated 
jr, where the stomach will receive and retain it, W2 may foJ 



Costiveness of the Bowels. 367 

low tho calomel by Rochelle salts or castor oil, in repeated 
dopes. 

When the stomach is very irritable, and frequent vomiting 
present, these symptoms will in general be relieved by the 
calomel and opium ; we may at the same time, however, ex- 
hibit the effervescing mixture (soda powders), and a large 
blister or mustard plaster should be applied over the stomach. 
In every case where the symptoms are violent and obstinate, 
the application of a blister or mustard plaster, after the em- 
ployment of warm fomentations has been continued for some 
length of time, will be of advantage, and should not be 
neglected. After the violence of the disease has been removed, 
we should next direct our attention to restore to the liver, the 
stomach, and bowels their healthy action. This is to be done 
by giving small doses, say five to ten grains of rhubarb, half 
vrain of opium, and half grain of ipecac every four hours. 

Of course the diet of the patient should be light, nourishing, 
easy of digestion, and taken in small quantities at a time. lie 
should particularly avoid all fat, coarse and irritating articles 
of food, all crude vegetables, and all stimulating liquors ; he 
thould make use daily of moderate exercise, but above all, 
riding on horseback. 

Bilious Colic is a disease which is easily reproduced by any 
impropriety of diet or regimen, or by exposure to cold or 
damp, and all these exciting causes of the disease should be 
carefully guarded against by the patient for some considerable 
time. He should be particularly guarded against over-heating 
himself, either by exposure to the sun or by over-exertion, and 
particularly when such has been the case, should he be cau- 
tious not to expose himself to cold, either by throwing off any 
portion of his usual clothing, sitting in a draught of air, going 
out into the night air, or Irinking cold fluids. His bowels 
should be kept moderately open either by the use of the ripe 
fruits of the season or some gentle laxative, and intoxicating 
drinks should be by all means avoided. 

COSTIVENESS OF THE BOWELS. 

The bowels, generally speaking, ought to operate thoroughly 
once in the twenty-four hours. In persons who do not expe- 
rience such relief it may be called a case of costiveness of the 
bowels. There are, however, exceptions to this rule ; with 
tome individuals, a single evacuation of the bowels once every 
three or four days, and even less often, seems to be sufficient, 
and perfectly compatible with their enjoyment of perfect 
health : and when such is the case it is of course superfluous 



368 Co8hveness of the Bowels. 

%o endeavor to correct it, and it is better to let well alono. If 
however, ii conjunction with this condition of the bowels, the 
person suffers from headache, from languor, from distention 
of the abdomen, if the breath is disagreeable, and the tongue 
furred, the state 5s not compatible with health, and should be 
corrected. 

There are numerous causes producing this disease, a few of 
which will be enumerated. The nature of the food, as might 
be expected, exerts considerable influence ; bread badly made, 
and especially if alum be mixed with it, cheese, milk with 
some persons, farinacious articles, such as arrow-root or ground 
rice, and food of too concentrated a character, all tend to pro- 
duce costiveness. Deficient exercise, particularly if combined 
with much exertion of mind ; any drain upon the system, as 
m suckling, abundant perspiration, loss of nervous power, an 1 
old age have the same effects. 

The large bowel is very frequently the seat of the costiveness ; 
it loses tone, allows itself to be distended, sometimes to a a 
enormous extent, or contracts to a very narrow calibre in soire 
portion of its course. Lastly, a very common inducing cauue 
of costiveness, particularly in females, is inattention to the 
Intimation of the laws of nature to relieve the bowels. 

Every effort should be made to correct the disorder without 
the aid of medicine. In the food, all these articles which have 
been enumerated, or which are known to produce costiveness, 
must be avoided. The bread used should be made of unbolted 
flour (called " Graham flour" sometimes) ; if vegetables and 
fruits agree in other respects, they may be freely consumed, 
and cocoa substituted for tea or coffee : food is not to be taken 
in a state of too great concentration, but so that by the hulk 
of its refuse it may afford substance to stimulate the action of 
the bowels. In addition, there are various articles of diet 
which exert an aperient or laxative effect, and which may be 
used or not, according to the taste of the person : such as 
Scotch oatmeal in the form of porridge, honey, prunes, etc. 
Exercise, whether on foot or on horseback, is another valuable 
aid in the removal of the costive state ; it not only quicken* 
all the functions, but it assists the action of the bowels by the 
mechanical motion communicated to them. Friction by rub- 
bing with the hand or coarse towel over the bowels, has a 
good effect. 

Another very important point is regularity in the rime of 
evacuating the bowels ; not waiting for the urgent sensation, 
but retiring for the purpose at one set period of the day, when 
time can be given, directly after breakfast, being the beat 



Costiveness of the Bowels. 369 

Persons who are liable to costiveness should give themselves 
at least a quarter of an hour, or even longer, for the daily 
evacuation of the bowels. 

In cases which are not benefitted by a diet of fruits, &c, as 
often recommended in this book, of course appropriate medi- 
cines must be used. 

If there is simple costiveness, without disorder of the diges- 
tive organs, the best remedy will be the regular use of injection 
of cold water every morning ; if, on the other hand, furred 
tongue, with acidity of stomach, flatulence, pain between the 
shoulders, headache, &c, betoken deranged digestion, medicine 
will be required, at all events in the first instance : the liver is 
probably at fault, and five or six grains of blue pill, followed 
in the morning by castor-oil, will be requisite to commence the 
treatment ; or seidlitz powders, or Rochelle salts, may be used 
instead of the oil occasionally. 

If the stomach, liver, and upper bowels have been well 
cleared by the above medicines, it is requisite to keep the 
bowels open ; otherwise a few days will see all the symptoms 
returned — and, in fact, such is too often the case. Persons are 
content with taking a dose of strong opening medicine every 
few days, or once a week, as the case may be, and rest content 
with thus having a good clearing out. The practice is one 
incompatible with sound health, and is most injurious to the 
stomach and bowels themselves : many cases of obstruction, 
and even inflammation of the bowels are produced by it. The 
principle to be proceeded upon in the treatment of costiveness 
is, that it is more easy to keep the bowels in action than to 
excite them to it when they have become thoroughly torpid, 
and therefore the individual should not rest content without 
the daily evacuation. 

If simple costiveness exists, caused by torpor or inaction of 
the lower bowel, injections of cold water up the bowels every 
morning will often cure it ; but medicine may be required, 
perhaps daily, for some time, or it may be used alternately 
with the injection. Some medicines are better adapted than 
others to the treatment of habitual costiveness, and of these 
castor-oil, aloes alone, or in its combination alternately with 
senna, and ipecac are the principal ; their great advantage ii 
not losing their effect by continued use. When castor-oil can 
be taken regularly, in most cases it answers extremely well ; 
and if taken regularly, the dose requires rather diminution 
than increase. It is a medicine, moreover, which never seem! 
to injure the tone or the mucous coat of the bowels. Aloes it 
peculiarly well adapted to relieve certain forms of costiveness, 



370 Diarrhoea, or Looseness. 

particularly that of sedentary persons, and -nay be taken h 
the form of pill, in combination with soap, five grains of each 
at bed time. 

Senna, in the form of the ordinary infusion, (tea) or pow- 
dered, and taken with syrup, is a safe, and at some time eifec- 
tive purgative, as it does not lose its effect, like many othei 
medicines. Or a quarter of pound of Epsom salts, dissolved 
in a pint of water, of which a wineglassful or two ie taken at 
Ded time, often operates freely next morning 

VIABRHCEA, or LOOSENESS. 

This complaint consists in a too frequent discharge froia 
the bowels, in consequence of their increased secretion and 
motion. The appearance of the stools is various : sometimes 
being thick, thin, slimy, whitish, yellow, green, dark brown, 
&c. Each discharge is preceded by a feeling of weight in the 
lower part of the belly, which, for the time, is relieved by the 
evacuation. The causes of diarrhoea are very numerous, but 
may, perhaps, be classed under three heads — nervous causes, 
causes which act upon the surface of the body, and irritatmg 
causes which act directly upon the bowels themselves. 

Influences affecting the surface of the body, particularly 
cold, and especially cold feet, often produce diarrhoea. Cold 
nights succeeding hot days are often said to occasion the dis- 
ease ; but it is also remarkable, that diarrhoea is apt to occur 
at the breaking up of a long frost — indeed to be epidemic, 
that is, of general prevalence. 

But it has been noticed that the most frequent cause of 
diarrhoea, however, is irritation in the bowels themselves, 
caused either by undigested or indigestible food, by acid, by 
acrid, morbid bile, or by the deficiency of that fluid permit- 
ting the digested food to become unduly changed. It may 
also be caused by costiveness, or by the lodgment of sucn 
matters as the skins of dried peas or beans, or of raisins, in 
the folds of the large bowel. Some persons habitually have 
a relaxed condition of the bowels, which is natural, and at 
the same time essential for health, and then to check it is 
dangerous. It is evident, that in a disease depending upon 
so many and various causes, a due discrimination of these is 
requisite for proper treatment. It must not, either, be lost 
sight of, that diarrhoea is in many cases salutary — an effort of 
nature to free the constitution from such morbid mattei 
which, if retained, would produce disorder or disease. On 
this account, the simpler forms of diarrhoea are better Lift t€ 
right themselves, so long sl» they keep within moderate 



Diarrhaa, or Looseness. 371 

bounds. This caution is particularly to he observed with 
regard to that which occurs in the teething of children, which, 
when moderate, is a safeguard ; but when it becomes so fre- 
quent that the child is evidently weakened by it, and especi 
ally if the evacuations appear to be losing their healthy 
character and become like shreds of skin, or streaked with 
blood — in such cases, a warm bath for six or eight minutes 
should be used, for two or three evenings in succession ; 
isinglass or gelatine given in the milk-food, and a teaspoonful 
of the castor-oil emulsion with the yolk of egg beat up 
together, in equal proportions, with a little mucilage of gum 
Arabic, given three or four times a day, each dose containing 
a drop of paregoric. 

In diarrhoea, resulting from exposure to cold, the best 
plan of treatment is to moderately re-excite the skin by giving 
small doses of ipecac every two hours ; taking in the mean- 
time some ginger-tea, mixed with a little blackberry brandy. 

If diarrhoea is caused by irritating matters in the bowels, 
one thing is evident — it cannot be properly relieved unless the 
bowels are freed from the irritating matters. It may, it is 
true, be stopped under these circumstances, but it will recur, 
unless the irritating substances have been removed by purg- 
ing, previous to the use of the astringent medicine, and the 
continuance of the diarrhoea is merely the consequence of the 
previous irritation. In many cases in which the diarrhoea is 
owing to irritating matters in the bowels, particularly to bile, 
all that is requisite is to diminish the acridity by means of 
drinks of slippery elm> or gum arabic water, or flax-seed tea, 
largely used, to which, if there is acid in the stomach, a little 
carbonate of soda or prepared chalk is to be added. In other 
cases, when the action of the bowels is constant, painful, and 
exhausting, it is absolutely necessary to check these symptoms 
in the first place, and to soothe the bowels, before means are 
resorted to for freeing them from the irritant cause. For the 
former purpose, a dose of paregoric, or a mixture of one tea- 
spoonful of paregoric, four tablespoonfuls of water, and one of 
prepared chalk, repeated if necessary, will answer as well as 
any ; or a strong tea made of allspice and cinnamon, with a 
little chalk, given every hour, will answer. Mustard to the 
bowels will ease pain, and often helps the disease very quick 
ly. If the active diarrhoea does not, from its comparative 
mildness, require these remedies at first, or when it is suffi- 
ciently moderated, the bowels should be thoroughly cleared 
out with a tablespoonful dose of castor oil, to which ten drops 
of laudanum may be added ; this will probably clear away trie 



372 Cholera. 

irritatkig matters, if they consist of indigestible substances. 
When castor oil cannot be, or is not taken, the best substitute 
is twenty grains of rhubarb and fifteen of calcined magnesia, 
with some aromatic, as cinnamon or allspice, or a teaspoonful 
of tincture of rhubarb, and, if there is much pain, five to ten 
drops of laudanum, the dose being repeated, if requisite. .Af- 
ter the action of the opening medicine, one or two doses of 
astringent medicine, as mentioned above, may again be re* 
quired, as the bowels are apt to keep up acting simply from 
irritability. 

If the disease has been permitted to pass into the stage of 
irritation, when there is tendency to fever, the belly tender, 
the tongue red, and the motions resemble shreds of skin, ot 
pieces of jelly, and are mixed with blood, the ease is of that 
■erious nature that medical assistance should at once be ob- 
tained, if it has not been so before. In the meantime, the 
mixture of castor oil with yolk of egg, in small doses, will bo 
found the safest and most effectual medicine ; two tablespoon- 
fuls, with five drops of laudanum, being given every four 
hours, and starch and laudanum injections, the diet being as 
unirritating as possible, and containing abundance of gelatine. 
A most excellent drink in these cases is rice-water, in each 
pint of which from a quarter to a whole ounce of gelatine or 
isinglass is dissolved, with a piece of toasted bread introduced 
to flavor it, or a little cinnamon. Also, a blister or mustard 
plaster will be of very great service in some cases. Flannel 
should be worn next to the skin in all these cases. 

CHOLEBA. 

As we do not propose making this a " historical" work, onlj 
a short chapter will be devoted to the subject of cholera, sim- 
ply giving its symptoms, its manner of propagation, the mean* 
of prevention, and its treatment. 

The true nature of this terrible disease is not known. How- 
ever, such is not the case with respect to those conditions of 
body, and still more with respect to the external circumstances, 
which favor the attacks of the scourge and foster it into 
activity. Dirt, bad air, bad water, bad food, insufficient cloth- 
ing, excitement of any kind, and irregular and vicious habits, 
all favor the production of cholera when the disease is pre 
vailing as an epidemic; and were it not for these, singly 01 
combined, it would, in all probability, become a comparative- 
ly manageable disease. 

The symptoms of this disease are pretty generally known, 
even to the unprofessional reader. However, a reference tc 



Cholera. 373 

the principal or more prominent symptoms, will be in placa 
here. 

The violence of its symptoms, and the fearful rapidity with 
which it often terminates life, render cholera one of our most 
alarming diseases. Occasionally, but more frequently in hot 
climates than in temperate ones, persons are, as it were, pros- 
trated at once by the cholera poison, and die, perhaps within 
an hour of the first attack, without any other symptoms than 
total collapse of the powers of life. More generally the sei- 
zure is not so sudden : probably there has been slight diarr- 
hoea, or rumbling movements of the bowels, with sinking 
sensation at the stomach, for some days previously ; or, at all 
events, the person has felt unwell. When the disease sets in 
earnestly, which in the larger proportion of cases it does dur- 
ing the night, the patient vomits, and is purged with more or 
less frequency and violence, the evacuations quickly coming 
to resemble thin gruel or rice-water ; cramps of the limbs suc- 
ceed, the surface becomes cold, blue, bathed in sweat, and has, 
particularly the fingers, a peculiar shrunken appearance ; the 
tongue is cold, the pulse imperceptible ; the urine is suppress- 
ed, and the voice acquires a peculiar pitch of tone. Many die 
in this, the collapse stage of the disease ; but if it is passed 
through, reaction comes on, the surface gets warm, the thirst 
continues, the quick pulse becomes perceptible, the tongue is 
dry and brown, and delirium is present ; in short, fever is es- 
tablished, and may end either in recovery or death. 

Many persons do wrong, during the prevalence of cholera, 
by making material changes in their ordinary modes of living, 
and, by so disordering the regularity of the functions, lay 
themselves open to attacks of the disease. Of course, if a man 
is aware that he is habitually indulging in practices injurious 
to health, such as intemperance, debauchery, &c. &c, he only 
acts wisely as regards his physical safety in changing those 
habits ; but it is hazardous to alter regular modes of living, 
which have hitherto been found compatible with good health 
— it being understood that whatever tends to lower the stand- 
ard of health favors the attack of the disease. There is, how- 
ever, one important precaution which ought to be observed, at 
all times, but more particularly during the epidemic of cho- 
lera : the perfect purity of the drinking water should ba 
ascertained, and its freedom from all decomposing orgcmit 
matters made certain. 

Care is also to be observed not to take active purgatives, 
especially salines, such as Epsom or Rochelle salts, seidlita 
powders, etc., which produce watery evacuations ; if aperient 



374 Cholera. 

»edicine is required, it ought to be of a warm character, snob 
at magnesia and rhubarb, with some aromatic, (cinnamon 01 
allspice), for whatever produces free action of the bowell 
apparently increases the susceptibility to attack. For this 
reason, too, the slightest tendency to diarrhoea should at one* 
be arrested by a dose of paregoric, or laudanam, or what i§ 
preferable, a mixture of prepared chalk, one tablespoonful, 
cinnamon or allspice powdered, one tablespoonful, white sugar 
and flour, one tablespoonful each, water, one wine-glass ; pare- 

foric, two tablespoonfuls ; Cayenne pepper, half a teaspoonful. 
lix, and take a teaspoonful every half hour, or as may be 
needed, and the use of milk and farinaceous preparations 
(corn starch, farina, flour, etc.,) containing gelatine, for food. 
The speedy adoption of these measures, in places distant from 
medical assistance, might do much to check the disease. 
Should the astringents above recommended fail, use the reme- 
dies recommended below. 

As to the actual treatment of the disease itself, when fully 
established, many different methods have been proposed and 
practised, and few of them, perhaps without apparent advan- 
tage in some cases, but as yet no treatment which can be 
oalled decidedly successful (a cure), has been discovered. 

The treatment which would be safe in the hands of others 
than medical men would be about the following : When 
vomiting and purging have set in, with cramps, give the fol- 
lowing mixture : Tincture of Cayenne pepper, laudanum, 
spirits of camphor, of each one ounce ; spirits of hartshorn, 
half an ounce ; mix together and take one tablespoonful every 
hour or half hour according to the symptoms. Or give one grain 
of opium, one of camphor, one of Cayenne pepper, (made into a 
pill with a little flour and water) every hour, or as may be needed. 

The patient should be wrapped at once in a blanket, or 
flannels next the skin. For the cramps use the following as 
a liniment : Tincture of Cayenne pepper, spirits of hartshorn, 
ehloroform, turpentine, or kerosine oil, two ounces of each. 
Mix and rub over the affected parts with a woolen cloth. Be 
oareful to remove the contents of the chamber from the room 
immediately and bury it in the ground. Also mix with the 
discharges from the stomach and bowels, as soon as voided, 
some sulphate of iron (common green vitriol), also dissolve 
some of the green vitriol in hot w T ater, and set the same in 
vessels around the room and in the different parts of the house ; 
and then throw some down the sinks, privy, cellar, and such 
places, once every day. Keep the sick chamber well aired, 
and by all means try to cheer and comfort the patient, so af 



Dysentery, or Bloody Flux. 375 

to keep up his spirits. A mixture of mustard and Cayenns 
pepper moistened with strong vinegar, applied to the stomach 
and bowels is good to check the vomiting and purging, or ap- 
plied to tiie limbs for cramps. 

During the prevalence of this disease the greatest care is 
necessary in regard to cleanliness, ventilation, etc. (See 
w IJow to Preserve Health" in first part of this work). It may 
be mentioned also that warm bricks or warm stones, irons, or 
hot salt should be applied to the limbs or body where there is 
coldness or cramps. An injection up the bowels of half a tea- 
Bpoontnl of laudanum, four or five tablespoonfuls of brandy or 
whisky, with a little thin starch, is often very beneficial in 
the active stage of this disease, to be repeated if necessary. 

DYSENTERY or BLOODY FLUX. 

This differs from diarrhoea, as may always be known by the 
symptoms*. In dysentery there is an inflammation of the 
lining or mucus membrane of the large bowels ; the stools 
are frequent and often bloody, attended with griping and bear- 
ing down ; the ordinary excrement being seldom discharged, 
and when it is, the quantity is small, and voided in the form 
of hard lumps. Fever very generally attends the acute form 
of the disease. 

Sometimes the disease comes on with shivering, succeeded 
by heat and thirst, and other symptoms of fever ; at others, 
tne affection of the intestines is the first symptom observed. 
There exists unusual flatulence in the bowels, severe griping, 
frequent inclination to go to stool, loss of appetite, nausea, 
vomiting, frequency of pulse, and a frequent discharge of a 
small quantity of mucus streaked with blood, pure blood, or 
of a peculiarly offensive matter by stool. The matter dis- 
charged from the bowels in dysentery, varies very much in 
appearance, in different cases ; being sometimes, as we have 
just- stated, pure mucus, or mucus mixed with blood ; pure 
unmixed blood, and in other instances, pus, a jelly-like dark 
colored matter, or a putrid watery mass, which contains films 
of a membranous appearance, or small fatty masses, floating 
in a large quantity of liquid matter. Hardened excrement 
is likewise sometimes passed. There is great emaciation and 
debility, a quick and weak pulse, a feeling of burning heat, 
and intolerable bearing down of the bowels. 

There are two forms of this disease, the acute or active, and 
the chronic. In the acute form, the symptoms are urgent and 
clearly inflammatory, the natural faece& (contents of the bowelsj 
very rarely appearing, the pain and bearing down great, and 
blood often passing in large quantities. 



376 Dysentery, or Bloody Flux. 

Usually the chronic species is a consequence of the acute, 
and is, as its name imports, of a less inflammatory and more 
protracted character than the latter : here the stools are often 
frequent, loose, and have much the appearance of the natural 
excrement, but mixed with blood and mucus, and passed with 
severe bearing down. 

The principal causes of dysentery, are suppressed pcrspira 
tion, a damp atmosphere succeeding to a high temperature, 
and exposure to noxious exhalations and vapors. The indica- 
tions of treatment in acute dysentery are to subdue the local 
inflammation, to allay irritation, and to restore a healthy 
secretion from the skin, and these objects are most certainly 
secured by leeches, calomel, and anodynes, especially opium, 
with ipecac. In the majority of cases, the application of leeches 
to the lower part of the belly will be very useful. In many 
instances a large blister or mustard plaster may be laid over 
the abdomen with advantage. 

When severe bilious symptoms are present, a dose of calo- 
mel or rhubarb, ten grains of each, may be advantageously 
employed, and followed in the course of a few hours by a dose 
of castor oil. 

A combination of calomel or blue mass and ipecac will often 
be found of inestimable service in this complaint. A grain of 
calomel or three of blue mass, a grain of powdered ipecac with 
a third or fourth of a grain of powdered opium, may be made 
into a pill, and given three times a day ; or, a grain of calomel 
and four grains of Dover's powder, made into a pill in the 
same maimer, may be administered three times a day ; the 
other measures above prescribed being previously employed. 
These combinations of calomel with an anodyne are sometimes 
of the greatest advantage. 

In the commencement of acute attacks of dysentery, more 
especially if the inflammatory symptoms run very high, opium, 
however, should not be given, either in a liquid or solid state 
until a dose of rhubarb and calomel, followed by castor oil, 
has been given, and the bowels cleared of their contents. In 
such a condition, our chief means must be directed to lessen 
the existing inflammation by leeches and injections of thin 
starch or flax-seed tea. As an anodyne in this complaint, 
there appears none so suitable and efficacious for general use 
as Dover's powder. If therefore, it is not exhibited through 
the day, as one of the principal remedies, a dose of eight 01 
ten grains may be given in the form of pills, every night. 

The diet should be mucilaginous and fluid, and coneisl 
ehiefly of barley, rice or gum-arabic water, during the inflam* 
matory stage of the disease, and this only in very small quan 



Dysentery, or Bloody Mux. 377 

titles. Subsequently preparations of sago, rice, arrow-root, 
milk and the like may be allowed, and to them the patient 
ihould be confined for some time after recovery. 

Sometimes when the patient begins to recover, his appetite 
being vigorous, he is apt to eat too much ; and care must be 
exercised not to exceed a very moderate quantity of food, even 
where the appetite is keen ; for if too much be indulged in v 
the bowels will suffer increased irritation, and a severe relapse 
invariably follows. 

Laying down in bed is the best position for the patient, and 
perfect rest must be constantly observed during the active 
stage of dysentery, and the greater the irritation the more 
requisite they are. The patient ought not to give way to the 
frequent inclinations to stool by which he is harassed, hut 
stifle them as much as possible. The stools must be im- 
mediately removed from the patient's chamber, which should 
be freely ventilated at all times, and kept perfectly clean. 

For the constant griping and bearing down which attend 
this disease, the best remedy is frequent injections of thin 
starch, combined with sweet oil, to each of which, after the vio- 
lence of the disease has been somewhat reduced, thirty to forty 
drops of laudanum may be added. 

Flannel should be constantly worn next the skin during and 
after the disease, and be careful to avoid dews, damp night 
air, and sudden atmospherical vicissitudes, more especially in 
hot or unhealthy climates. 

If pain and irritation are still occasionally felt, four or five 
grains of Dover's powders may be given at bed time. 

In the protracted species of the disease (chronic dysentery,) 
in which the acute inflammatory symptoms have subsided, or 
been subdued, our objects are nearly the same as in the acute 
variety, only we are called upon constantly to remember, that 
debility is invariably associated with this form of the com- 
plaint, and therefore every means of preserving and increasing 
the general strength must be employed. Local bleeding by 
leeches or cups will, in most cases, be demanded if the strength 
is sufficient ; in conjunction with which, one of the best reme- 
dies yet discovered for chronic dysentery is calomel or the 
blue mass, combined with ipecac and opium, with frequent 
frictions of the skin, rest, and properly regulated diet. Many 

Eatients, tormented for a long time by this painful malady, 
ave been speedily relieved and ultimately completely cured 
by this plan of treatment. It is equally adapted to the pro- 
tracted dysentery so often met with in hot climates, and to 
that of colder regions. 



373 Cholera Morbus. 

Three grains of calomel, two of ipecac, and one of opium, 
given three times in the 24 hours, followed next morning bj 
a teaspoonful of oil, is a good proportion of the remedies. 

The patient must constantly wear a flannel bandage round 
fche bowels, and keep the feet and legs warm by wearing 
woollen stockings and drawers. 

CHOLERA MORBUS, or VOMITING AND PURGING* 

This disease is occasionally ushered in by chills, pains of the 
head, giddiness, propensity to sleep, and a sense of numbness 
in the limbs. Sometimes the disease commences gradually ; 
at others, it attacks suddenly. At first the patient is troubled 
with some belchings and pains in the stomach ; these symptoms 
are soon followed by vomiting, which is almost constant. At 
first the contents of the stomach are discharged ; afterwards 
a fluid, sometimes green, whitish or colorless, and at others, 
dark colored, or even black. Discharges from the bowels of 
a similar character occur simultaneously with the vomiting. 
The patient, at the same time, experiences great thirst, pains 
in the stomach and bowels, and tension or fullness of the 
abdomen. If the disease be violent and protracted, the limbs 
are affected with spasm, the strength is greatly prostrated, 
the surfaces of the body and limbs become cold, the pulse 
small, frequent and often imperceptible, a cold clammy sweat 
breaks out, and is succeeded by continual hiccup, delirium 
and death. 

In the ordinary cases of cholera morbus, particularly when 
the discharges are green or tinged with bile, the best practice 
is to give the patient, plentifully of some mild diluent drink, 
as toast, gum, barley, slippery elm, or rice water ; to p^ce 
his feet in warm water, and subsequently administer an injec- 
tion of a pint of thin starch, a teaspoonful of sweet oil, and 
forty to sixty drops of laudanum. 

If the case is violent, especially when the pain of the bowels 
is constant and severe, the free application of leeches or cups 
to the abdomen, mustard poultices to the extremities, and the 
administration by the mouth of a grain or two of opium, in a 
pill, or a teaspoonful of paregoric, with twenty drops of 
essence of peppermint, to be repeated in an hour or so if 
necessary, will be demanded, and will often arrest the disease 
almost instantly. The same injection as recommended abo\e^ 
will also be beneficial when the discharges from the bowels 
are frequent and copious. After the vomiting aad purging 
are suspended, it will be prudent to administer a dose oi 
calomel, or a pill composed of blue mass ten grains, and opium 



Diabetes, or Great Flow of Urine. 379 

one gram, which may require probably to be repeated on the 
ensuing day ; the patient at the same time connning himself 
strictly to thin gruel or panado, encouraging the healthy 
functions of the skin by the warm bath and trictions of the 
skin. 

When the powers of life appear to be sinking, the skin 
becoming cold, the pulse small and feeble, and a constant 
hiccup taking place after the vomiting, the patient should 
.bave stimulants, as brandy or whisky, with small pieces of 
Ice, and also injections of thin starch and whisky up the 
towels occasionally, with warm bricks, &c, to the extremities, 
and brisk frictions, and mustard poultices applied to the inside 
of his legs and arms, and over the stomach. As it is all-im- 
portant in these cases to put as early a stop as possible to the 
discharges from the bowels, whith often continue after the 
vomiting has ceased, injections composed of a pint of water, 
in which has been dissolved twenty grains of sugar of lead, 
and two grains of opium, may be administered every three or 
four hours ; or injections of allspice tea, cold, in same quantity, 
Vs often a good remedy. 

DIABETES, or GREAT FLOW OF URINE. 

In this disease there is discharged an unusual large quantity 
of urine ; sometimes the amount is enormous, and the urine 
contains a great deal of saccharine (or sweet) matter. The 
attack of this complaint is generally slow ana gradual ; the 
nrine is clear and transparent as spring water, and accompa- 
nied by a faint smell, as if mixed with rosemary leaves. These 
symptoms generally occur without pain, and are usually 
attended with a voracious or greedy appetite. The serious 
nature of the affection renders it one of those which should be 
trusted for treatment only to medical hands. The same reason 
renders it important that its first symptoms should be known, 
that they may not be neglected. It may creep on a persor 
insidiously, or be suddenly developed. The first and mosl 
prominent symptom which usually awakens attention, is the 
frequent call to pass urine abundantly, at the same time the 
thirst is extreme. 

In addition to the symptoms already mentioned, the mouth 
f§ dry, and the tongue clammy and sticky, often very red ; 
there is flatulence and indigestion, and the bowels are generally 
costive. Emaciation and general debility also occur ; pain and 
weakness in the loins, and feebleness of the limbs. The lead 
ing symptom, however, is the discharge of urine, which haf 
been known to exceed forty pints in the twenty four hours, 



380 Diabetes, w Cheat Flow :f Urine 

At the commencement of the disease the urine may still retaic 
the urinous properties of the diluted secretion ; but this passe* 
into the saccharine (sweet) condition. If yeast be added to 
the urine, it ferments, and alcohol is formed, the sugar par- 
taking more of the character of grape, or fermentable sugar, 
than of the cane. Diabetes is often accompanied by other 
diseases, especially by pulmonary consumption. The dietetic 
treatment of diabetes is probably of more importance than th* 
medicinal ; the chief precaution being the avoidance of what 
ever — either sugar of any kind, or vegetable starchy matter- 
is capable of being converted into grape or fermentable sugar 
This, of course, involves the prohibition of bread made from 
ordinary flour, which contains all the starchy matter of the 
grain. This privation is always much felt and complained of, 
and various substitutes have been proposed. The following, 
by Dr. Percy, is probably the best : — " Take sixteen pounds 
of potatoes, washed free from starch ; three-quarters of a pound 
of mutton suet, half a pound of fresh butter, twelve eggs, half 
an ounce of carbonate of soda, and two ounces of dilute (half 
water and half acid) hydrochloric, (muriatic) acid. This quan 
tity to be divided into eight cakes, and baked in a quick oven 
until nicely Drowned. 

" It is, as must be obvious, an expensive article, but with 
many diabetic patients this will not be an object of considera- 
tion. It is somewhat improved in taste by being slightly 
toasted." 

Animal diet is principally to be depended upon for nour- 
ishment, and some of the green garden vegetables, such as 
rpinach, are permitted. Distilled water, 01 boiled water, but 
not toast-water, may be used for drink. Dr. Prout, in some 
cases, found porter beneficial ; and, in France, claret has been 
given with advantage. 

Persons who suffer from any suspected tendency to diabetef 
cannot attend too strictly to the state of the digestive organs. 
Wet feet must be particularly avoided, and flannel should be 
worn next to the skin ; while all sources of debility must ba 
guarded against. 

All that can be done by others than medical men, will be 
to follow out the directions given above, as regards diet, &c; 
also keeping the bowels open by mild purgatives, as castor oil, 
&c, and if there is restlessness at night, twenty drops of 
laudanum, or a teaspoonful of paregoric, at bed time. It has 
been stated by some medical men of eminence that emetics «* 
ipecac, given once a day for a few days, has checked th« 
disease and the patient has recovered. It is worthy of a tria^ 
where you can not have the attendance of a medical man. 



Bloody Urine. 381 

BLOODY URINE. 

Thib is produced by external violence, as blown, bruises, &e. • 
or it may be the consequence of violent exercise, as in riding 
or jumping ; or it may be occasioned by the irritation of a 
itrne in the kidney or bladder ; it may also take place with- 
out any cause that we are able to ascertain. In some cases, 
tLe quantity of blood voided is very large, and the debility 
Sniuced is very alarming. In the treatment of the disease, we 
are to be guided by the cause by which it has been produced. 
WTien it is occasioned by external violence, we are to dimin- 
ish inflammatory symptoms by topical bleedings, (leeches, and 
cupping over the lower part of the abdomen and small of the 
back,) by giving mild purgatives, and directing the patient to 
drink largely of diluent drinks, such as flaxseed tea, lemonade, 
&c, to which a little spirits nitre may be added, in order to 
dilute the contents of the bladder. If the symptoms lead us 
to believe that stone or a gravelly complaint is the cause of 
the disease, that must be attended to, for the treatment of 
which, see " Gravel." The spontaneous voiding of blood is to 
be checked by the application of cold to the region of tho 
bladder, and by injecting cold water into the bowels. Small 
doses of opium, laudanum, or paregoric, may be given to al 
lay irritation. Blood is sometimes discharged with the urine, 
mixed with matter. In all of these cases, a tea made of equal 
parts of uva ursi and buchu leaves, taken in doses of a wine- 
glassful, three or four times a day, are the best remedies. 

RETENTION OF URINE. 

By this is meant that the urine, though secreted by the kid- 
neys and conveyed into the bladder, it is not discharged in the 
usua way. 

The distinguishing symptom is a swelling at the lower par* 
of the belly, occasioned by the distended bladder, and accom- 
panied by pain on pressure ; fever, and deficiency of urine, 
either total or partial. Sometimes the bladder may be dis- 
tended, although there may be a partial flow of urine, and 
without g?3at care patients may be deceived by this circum- 
stance. Li violent efforts at expulsion take place, some por- 
tions of urine may be discharged, and the patient may b* 
Supposed merely to labor under a strangury, ^or difficulty ia 
Toiding urine.) By examination of the lower part of the bel 
ly, and the introduction of the catheter, the disease may, 
however, almost always be ascertained. Retention of the 
urine may arise from palsy of the bladder, which is not an 
unusual occurrence in advanced life. 

Palsy of the bladder may be owwg to a person acquiring 



282 Suppression of Urine. 

the habit of not evacuating the bladder when nature prompt* 
him to do so. Retention of urine occurs also in the malignant 
forms of typhus fever. It comes on sometimes gradually, 
with a degree of debility which hinders the patient from com- 
pletely emptying the bladder, so that he still feels a desire to 
ao so. The inconvenience increases ; at length, the patient ia 
unable to discharge any urine, and the bladder becomes dis- 
tended. In cases of retention, the urine is to be drawn off by 
the catheter, and when relief is given by this means, it is not 
unusual for the bladder to recover its tone ; pretty speedily, 
when the complaint has come suddenly on, and more slowly, 
when it has been gradual in its progress. In addition to tne 
regular emptying of the bladder by the catheter, we are to 
try the effect of cold applications to the parts, and of blisters 
to the lower part of the back. 

Regularity in the times of passing the urine will have a 
beneficial effect also. Sometimes ten or twenty drops of tinc- 
ture of cantharidcs (Spanish fly,) taken three or four times a 
day, will excite the bladder to contraction, and the urine be 
thus thrown off. 

SUPPRESSION OF URINE. 

This is a condition of the system in which the urine is not 
iecreted in the same quantities as usual ; it is in one respect 

J'ust the opposite of Diabetes, or too great a secretion of urine. 
t is mostly a disease of old persons. The symptoms are : the 
patient passes no water, and if the catheter should be introduc- 
ed, still none passes ; the patient complains of feeling " un- 
well ;" sometimes there is nausea and restlessness at night ; if 
there is much perspiration, it has the smell of urine. 

The treatment consists in putting the patient into a warm 
bath for fifteen or twenty minutes ; the application of cups 
over the kidneys, followed by mustard olasters, or warm fo- 
mentations of hops, flaxseed meal and slippery elm. Give a 
dose of Epsom salts or castor oil, and also twenty drops of spi- 
rits nitre in a little gum-arabic water, every hour. Some 
times a tea (given cold) made of peach leaves, uva ursi or bn 
chu, and taken freely, will have the most happy effect. Or 
a strong tea made of Virginia snake-root, given hot, every 
hour, to pioduce perspiration, will start the secretion of thf 
kidneys. 



Strangury — Diphtheria. 383 

STRANG UJR Y. 

This is a frequent desire of making water, attended with 
much difficulty and pain in voiding it. It arises from various 
causes, as an inflammation of the urethra, of the neck of the 
bladder, or of other neighboring parts ; the application of a 
blaster when the matter of the cantharides is taken into the 
body j the internal use of cantharides in powder or in tincture ; 
axcess in drinking wines or spirituous liquors, or from gravel- 
ly particles in the passage. It is sometimes a symptom of 
gout, and very often arises from disease of the prostate gland, 
^situated at the neck of the bladder.) When strangury is 
owing to the application of a blister, the patient should take 
plentifully of diluent drinks, as barley-water or thin gruel, 
slippery elm or gum-arabic water ; to which a little spirits 
nitre may be added. In severe cases, fomentations or poul- 
tices to the urethra and neighboring parts may be required ; 
and it will be proper to use injections to evacuate the bowels, 
as the accumulation in them will increase the strangury, from 
whatever cause it" originates. If the strangury is an attend- 
ant on inflammation, it must be treated by local blood-letting, 
by leeches, by cooling purgatives, by fomentations, the warm 
bath, &c. ; and if from spasm, an opiate (laudanum or pare- 
goric) by the mouth or by injections, according to age, &c, 
will be proper and beneficial. 

DIPHTHERIA. 

This is a peculiar affection, met with mostly in children, 
and is characterized by a feeling of great prostration and want 
of appetite ; paleness, dryness, or a feeling of roughness in the 
throat ; swelling of the tongue and at first, perhaps, a little 
redness about the palate, &c. This feeling may continue a 
day or two, or more, before more active symptoms set in. 
Then, on examining the throat, palate, &c, it will be observed 
that they exhibit small, white, or yellowish patches, having 
a lardy or curdy appearance ; there is also at this time swelling 
of the glands of the throat, some difficulty in swallowing, &c. 
The patches are at first small and distinct from each other, but 
may soon spread until the inside of the mouth and throat are 
covered. 

In a short time a bloody fluid oozes from the affected parti, 
coloring the spittle. There are also at this time red and 
inflamed spots or patches on some part of the throat ; some- 
times it is of a greyish color, and looks as if it had been 
cauterized or burnt with caustic. There is also, in bad cases, a 
discharge of a thin, offensive fluid, sometimes tinged with 



384 Diphtheria. 

blood from the nostrils and the mouth; and also at timet 
bleeding from the nose. This false membrane, or patches, if 
thrown off from time to time, but is speedily reproduced, 
though thinner and of a more whitish appearance. Sometime! 
these patches of false membrane become softened and mixed 
with the spittle, or absorbed, instead of being thrown off. 

This disease, when it terminates fatally, generally does so 
by the peculiar inflammation extending into the stomach and 
bowels, or the lungs. Whitish patches sometimes appear in 
ordinary sore throat, so that you must not take this as a sure 
symptom of diphtheria ; the latter can be told by the fact that 
the patches do not extend, and being of only transient duration. 

Diphtheria is usually regarded as a contagious disease, and, 
of course, other children should be kept out of the apartment;, 
also let brown sugar be burnt on live coals or a hot iron, once 
a day, and chloride of lime kept in open vessels in the different 
rooms, especially in the sick chamber ; or green vitriol dissolved 
in hot water may be set in open vessels about the apartments 
and the place — kept well ventilated. The attendants on the 
sick should also carry a mixture of gum camphor and green 
vitriol in a little bag about their persons. 

By all means have a physician at once in this disease, ii 
possible ; but when you can not, the following treatment ia 
advised : — Dissolve one heaping tablespoonful of common salt 
in a pint of lukewarm water, and with this let the throat be 
gargled every hour; also let the patient take a little salt in the 
mouth occasionally, and when dissolved, swallow it. Give 
plenty of flaxseed tea (cold,) or lemonade, mixed with slippery 
elm, or gum arabic water, thin gruel, &c. Apply poultices 
sprinkled with Peruvian bark (not too warm) to the neck, and 
give a mild purge of castor oil or rhubarb. Then follow by 
giving a tea made of Peruvian bark (cold), every three hours, 
or one or two grains of quinine three times a day. Inhalation! 
of bitter herbs (to which add some Peruvian bark,) as men 
tioned under head of catarrh in the head, where the patient is 
old enough to use it, three or four times a day, should also be 
tried ; or, if too young, let the vapor of burnt tar be inhaled, 
which can be done by burning the tar in the room. Gargles 
of oak bark or tar water may be necessary also. A solution 
of nitrate of silver, fifteen grains to the ounce, is applied by 
physicians, with a sponge or mop, to the affected parts. 



385 

LIST OF MEDICINES. 

Their Doses and Uses, 

Proper Time to Give Medicines. — This is a matter of con- 
siderable importance, and should not be overlooked. There 
are certain times of the day more convenient than others for 
giving some medicines. Purgative medicines should, in 
general, be given late at night, or early in the morning ; the 
bowels not being so easily acted upon during the time of sleep ; 
far this reason pills and other medicines which do not aok 
speedily, when given in the evening, have time to dissolve 
fVdly, and to produce their due effect on the bowels. Saline 
pnrgatives, such as salts, &c., are best given in the day time, 
that the cooler state of the surface may determine their action 
to the kidneys. . Emetics are best given in the evening, as 
tl ey produce tendency to sleep and perspiration, which are 
b ist encouraged by retiring to bed. Medicines for perspira- 
tion, should not be given during the process of digestion. 

QUALIFICATIONS OF ATTENDANTS ON THE SICK, 

There is very little doubt but that recovery from sickness 
depends materially on the nurse, or attendants upon patients, 
as well upon refraining from officious interference, as giving 
timely attention. All the necessary qualifications can seldom 
be found in any one ; but the nearer they can be got to follow 
the following directions, the better : 

Great attention to cleanliness of the mouth, the body, the 
bed, and the room ; often washing the mouth, and speedily 
removing all filth ; changing the clothes witii as little labor to 
the sick as possible, being careful not to give them cold — the 
greater the perspiration, the more frequently changing will be 
accessary. 

Keep the room always of a moderate degree of warmth, 
regulated by the season, with that all-important article, more 
wanted in sickness than in health, fresh air, to be gently 
admitted without a current, and no bed-curtains being allowed. 

Keep quiet ; disturb the sick as little as possible, by talking 
or making any kind of noise ; never communicate anv bad 
aews, — remembering that perfect rest to the patient is of great 
importance. 

Administer with faithfulness, and in the most palatable state, 
the medicines prescribed, and observe their effects: which 
report to the prescriber. Unpalatable pills may safely be 
•unrounded by a thin piece of paper, jelly, or gold leaf; the 



386 List of Medicines, 

great disgust to medicine being frequently caused by the 
nauseating manner in which it is given. 

Have in readiness a bed-pan, and never suffer the patient 

hen very weak, to sit up on it long, as in that state they 
may expire from exhaustion. A cheap and ready mode at an 
times, of making a proper pan, would be to saw down a pai 1 
or bucket to a depth of three inches, on which a top can be 
placed, with a hole in it like that of a privy. This of course 
applies to situations in which no better facilities are at hand. 

Keep constantly a supply of various articles for drink, in a 
proper state of the weak kind of teas, in addition to such 
medicinal drinks as are prescribed, which, when solely en- 
forced, prove disgusting ; remember to give but small 
quantities at a time / not very cold, as they increase thirst. 
brinks can be made of any of the garden herbs generally used 
for teas ; of toasted bread, barley, of apples, cut up in water 
of gruel, elm-bark, flax-seed, of lemonade, of chicken, or lean 
fresh meats, of tamarinds, vinegar, or cream of tartar, of cur- 
rant jelly ; in short, of any thing used in families, possessing 
no stimulating powers. Spirits, in any state of combination, 
wine, porter, cider, and the like stimulating drinks, unless 
particularly directed or called for from fainting or the disease 
of the patient, must be carefully avoided. 

Diet is a subject too, to which the nurse should pay the 
greatest attention. As this must vary with each varying state 
of the system, it is impossible to give any further directions 
in this place, than to state that in high fevers, it should be 
very moderate, entirely of small quantities of vegetables, and 
that in low fevers, it should be of well-seasoned, palatable 
food ; the more like that the sick person had been accustom.ed 
to, the better ; but take care to give it often, and little at a 
time, as a full meal, in such states of system, often produce* 
death. 

INJECTIONS. 

Administer an injection when required, of whatever article 
directed. These often operate only by their bulk ; and, un- 
less given as medicine, their component parts are not mate- 
rial ; they are generally made of warm water, with salt, 01 
soap, or sugar, or oil, and the common syringe is the instru- 
ment generally used ; but the best kind is what is called the 
Rubber Extension Syringe, to be found now in most drug 
stores. In order to give it, the patient should be laid on the 
side at the edge of the bed, a little over the edge, the knees 
drawn up near the belly, and then the pipe, with the fingei 
before it, is to be applied to the fundament ; and on pushing 



Their Doses and Uses. 387 

t m, the finger is to be taken away. It is gently to be pushed 
a little backwards, or towards the back bone, and then the 
contents is to be forced out with one hand while with the other 
the syringe is firmly held. It only requires that the injection 
should be made stronger, to irritate and excite the lower part 
of the bowel, which brings on the action of the rest of the 
boweh by sympathy. 

C UP P ING. 

This is an operation, so easily performed, and often so im- 
portant, that all ought to learn how to do it. If blood is to 
be drawn, the part ought to be cut in many places, each cut 
about the length and distance of a finger-nail apart ; the cut 
only deep enough for a little blood to How ; then a glass, or 
mug, or a gourd, of suitable mouth, is to be taken from a basin 
of hot water, and fitted to the part ; then a bit of paper about 
as large as a dollar, dipt in spirit, is to be held near the cup- 
ping-glass, and set on fire by a candle, when, as soon as it 
blazes, the cupping-glass being leant on one side, the burning 
paper to be quickly thrown into it, and then the glass applied 
close to the skin, as when first fitted. As the paper burns, the 
air will consume, and thereby cause the extraction of the 
blood. Paper burnt brown, or any inflammable article is often 
made to answer ; but the use of spirit is to be preferred. A 
small quantity of spirit put in the cupping-glass and set on 
fire will answer without paper : and its blaze is less apt to 
burn. There are articles made for the purpose of cupping, to 
be had in drug stores, in cities, much better than the rude 
apparatus here referred to, but in country places they are not 
likely to have them. 

DRESSING BLISTERS. 

If it be desirable not to keep the blister running, then make 
a very small opening with a needle or scissors, and let out the 
water very slowly, holding cloths to absorb it ; and apply to 
the part cabbage leaves, freed of their stem, warmed and 
rubbed before the fire, or paper moistened with lard. Plasten 
of tallow, or suet, or of hog's lard, will answer. When the 
blister is to be kept running, the skin should be cut off with 
acissors, and such stimulating ointment applied, as 6hall be 
directed. Basilicon ointment is often used, as also a very 
weak blistering plaster. 



388 List of Medicines. 

BANDAGES. 

That meat commonly used is a long piece of cotton* linen! 
or flannel, about three inches wide, rolled up smoothly ; itl 
application is to be equal, compressing no one part more than 
another ; and to insure this, you begin at the extremity of the 
toes or fingers, and wind it around, making each edge lap an 
inch over the other ; and when the part over which it goes is 
irregular, the bandage is to be so turned, edge for edge, that 
it shall become suited to the bulging or irregular parts it has 
to pass over. This properly applied, is a powerful remedy 
in sores, but does great harm when put on so as to produce 
unequal pressure, interrupting the circulation and thereby in- 
creasing the disease. 

There is another kind of bandage called the eighteen tailed 
bandage — because generally made of that number of slips of 
cotton or linen, of length sufficient to go once and a half 
around the part to be bound up. This is used when it is im- 
proper to move the limb. These detached pieces, in number 
sufficient to bandage the part needing it, are put under the 
limb at its first dressing — one to overlap the other about an 
inch ; then the ends are to be wound smoothly around the 
limb, the one end over the other ; and they of course will lap 
half around the part and each end will bind the other. When 
they are to be removed for dressing, and are found filthy, each 
can separately be pulled out, with a clean one attached to its 
end, and in that manner carried to replace that removed, 
without moving the limb. 

TO ULTICES. 

The chief object of poultices is to relax the skin over which 
they are placed and allay irritation. When made of Indian 
corn meal, or bread and milk, they should be soft, and the 

Eart going in contact should be greased. The best is made 
•om flax-seed meal, made by pounding it or grinding in a 
coffee-mill. The powder is gradually to be added to hot 
water and stirred until it is of proper consistence. A poultice 
made of slippery elm bark cut small, and boiled with a little 
Indian meal, is very soothing, as also one of thick jelly of 
water-melon seed, obtained by well boiling the seed in a littl 
water. In most cases the chief good is derived from th 
moisture or warm water, which can be fully had by simply 
dipping cloths in hot water and applying them, to be re 
moved on becoming cold and soaked in hot water agaip 



How to Apply Bandages. 889 

How to Apply Bandages.— The art of applying a 
bandage well, that is, both neatly and efficiently, require! 
Borne practice and attention, but it is often a most useful 
accomplishment ; for a bandage, if required at a.i, must be 
properly applied, otherwise it is worse than useless. If, there- 
fore, none but the surgeon can undertake the task, it neces- 
sitates a much more frequent attendance on his part, than 
might otherwise be requisite. In general, the first few appli- 
cations of a bandage will be made by the medical attendant 
himself, and ought to be in the presence of the individual to 
whom the duty may be afterward deputed. By careful atten* 
tion on the one hand, and kind explanation on the other, 
much may be learned and taught, but not all, as the inexpe- 
rienced bandager will discover on the first attempt. By all 
means, therefore, let the first attempt be made on some one 
in health, before the call is made to the invalid. Attention 
to the following directions will facilitate the application of 
the previous practical lesson, or in some measure supply its 
place, if from circumstances it has been wanting. Whatever 
the material, the width of the bandage or roller must be pro- 
portioned, in some degree, to the size of the part to which it if 
to be applied. If too narrow, it is apt to be stringy, and to cut ; 
if too broad, it does not adapt itself readily to the inequalities, 
and the pressure is unequal. For an ordinary sized adult male 
leg, a bandage of 2^ inches broad is a good proportion ; for 
the arm of the same person, one of two inches ought to be 
sufficiently well adapted. The material for bandages must 
neither be too strong nor too weak ; ordinary " shirting " or 
" calico " is a very convenient texture. The length, of course, 
must vary according to what is required, but rollers are 
usually put up in six or eight yard lengths ; they are better 
torn in one continuous strip, free from joinings, and without 
selvage edge. The strip, when prepared for use, must be 
rolled up as firmly as possible, into a single head. If the 
bandage is a new one, of calico or linen, the loose threads of 
the roll at each end must be roved off, otherwise they become 
troublesome when the roller is applied. Bandages mas be 
applied in simple circles (B), in spiral, etc., or in reverses ^<J). 
They are also applied in various other forms, to suit the differ 
ent portions of the body. In applying a bandage, the rolled 
up strip being held in the right hand, the end which is com 
menced with is secured by the first turn. If it be the simple 
circular bandage, round the trunk of the body, or round a 
limb of nearly equal girth throughout, either naturally or 
from swelling, the roller is carried round and round, each suc- 
ceeding turn slightly overlapping the one before it. If the 



390 How to Apply Bandages. 

iDiral bandage be required, the rolls are carried up very 
obliquely ; but if, as most likely, it is the reversed bandage, 
then wherever the inequality of the parts prevents its being 
laid on flatly and evenly, the bandage must' be turned upon 
feself (C), so as to become reversed, the surface of the cloth 
which was next the skin being turned outward, and vice 
versa. It is difficult to describe the manoeuvre, and it is a 
ittle difficult at first to execute it neatly and well ; but when 
practised, it becomes perfectly simple. This is by far the 
most useful form of bandage, and a person who can put it on 
well, will have but little difficulty in accomplishing the other 
varieties. For the purpose of retaining dressings upon the 
head, nothing answers better than a close-fitting calico cap ; 
a handkerchief will often serve every purpose, or the split 
cloth may be used ; applied as seen in the engraving, by the 
upper tails being brought beneath the under ones, and fas- 
tened under the chin, the under tails being cairied to the 
back of the head. When it is desirable to retain the head in 
me position, it may be done by bands attached to a cap, and 
fastened as required to a band going round the chest. When 
tor this purpose, or to fix a broken rib, such a band is requir- 
ed, it ought to be from eight to ten inches wide, made of toler* 
ably strong double calico, and sewed firmly round the body. 

To retain a fad or poultice in the armpit, a good sized 
handkerchief answers better than any bandage, the middle 
being placed at the armpit, the ends crossed, at the side of 
the neck opposite, carried under the corresponding armpit, 
crossed and brought and tied on the shoulder. For the groin 
and parts adjacent, the spica, or figure of 8 bandage, is also 
used. A roller eight yards long is taken, the end secured by 
one or two turns round the pelvis (hips), and then the band- 
age is brought down across the front of the thigh, carried 
evenly between the legs, and again brought up and carried 
round the pelvis : this being repeated at each turn till the 
»^ller is exhausted. As a general rule, leg bandages, habit- 
ually worn, ought to be put on before the individual gets out 
of bed in the morning. A bandage which gives pain after its 
application, without obvious cause, ought to be taken off, an*} 
be reapplied. If there is reason to suspect inflammatory 
swelling beneath, it will be well to try the use of cold water 
before disturbing matters. 

There is some little management required in taking off a 
roller, as weQ as putting it on. As each successive turn is 
unrolled, it should be gathered in a bunch in the hand, and 
not, as is often done, three or four yards of bandage at fall 
length pulled round the limb every time. 



391 



CLASSIFICATION OF MEDICINES. 



Tub medicines wanted for common use are very few : although such ao 
immense variety is to be found in apothecary shops. They are all arrang- 
ed under different heads, according to their most conspicuous effects upon 
the system. Under each head will be mentioned those deemed most im- 
portant in common use. 

Remember that in taking medicine of any particular kind, the system 
becomes habituated to it, and requires an increased dose ; therefore, medi- 
cines of similar nature ought often, when practicable, be substituted far 
the cae previously taken. 

The doses stated are for adults — the ratio of doses for children will be 
found under Tabular list of Medicines. 

F URG ATI VES.— Medicines which Open the Bowels. 

Saline Purgatives, (or Salts.)-— Epsom salts, Glauber salts, Rochelle salts. 
Dose of each one ounce, (about one tablespoonful) given dissolved in a 
glass or cup of cold water, on an empty stomach, the morning being pre- 
ferable. Dose for children, about half the above quantities, or less, ac- 
cording to age. 

Seidlitz Powders. — The contents of one Hue and one white paper, taken 
on an empty stomach, or the contents of two blue and two white papert 
may be taken ; directions go with the seidlitz powders ; for children about 
half doses. 

Phosphate of Soda. — This is a tasteless salt, and on that account is well 
adapted to children, as it can be given in soup, or beef tea; dose from one 
to two teaspoonfuls. 

Castor Oil. — This is a standard article, the world over, almost. Dose 
from one to three tablespoonfuls for a grown person, and children in pro- 
portion to the age. To prevent castor oil from griping, let it be taken 
with a few drops of essence of peppermint or cinnamon and some loaf 
sugar ; or for grown persons it may be given in some cold coffee or le- 
monade. 

Senna Leaves. — A small handful (three drachms) steeped in half pint of 
water for an hour, (like tea,) a few caraway seeds, some orange or lemon 
peel, tamarinds or sassafras bark, added to th« senna, prevents it, to a 
great extent, from griping. This is not a suitable purge for children. 

Sca/tfimony — In powder ; dose from three to ten grains, for grown per- 
sons. 

Jalap—hi powder ; dose from ten to twenty grains. 

Gamboge — Dose from two to five grains, in powder. 

Rhubarb — The powdered root ; dose from ten to twenty grains. 

Cream of Tartar and Sulphur — Mix one tablespoonful of sulphur with 
Iwo of cream of tartar, to be taken in a glass of cold water on an empty 
Stomach ; or for children, take the above quantities of each, mix thorough- 
ly with symp or molasses, and give one half in the course of the day ; the 
balance the next day, if needed. 

Aloes, — Dose in powder, five to fifteen grains, in tincture, one to tWQ 
tablespoonfuls ; for children, half the dose. 



392 Classification of Medicines. 

Calomel, is not often given alone as a purgative, except in cases of great 
Irritability of the stomach ; five to ten grains, in a pill, will sometimes re- 
main on the stomach when nothing else will. Some other purge musf 
always be given in twelve hours to carry off the calomel, to prevent sali 
nation. 

Active or Brisk Purgative — Jalap, ten to twenty grains ; cream of tar- 
tar, thirty grains, for a grown person. 

Manna, is a £ood purgative for children ; dose from one lalf to twt 
drachms, according to age. 

Castor Oil Mixture — Powdered gum-arabic, a heaping teaspoonful, po * 
dered white sugar, two teaspoonfuls ; peppermint or cinnamon water, twc 
ounces; mix. these together, and add a tablespoonful or two of castor oil, 
or less, of course, for children. (The peppermint and cinnamon water it 
made by dropping a few drops of the essence into cold water.) 

Oil of Turpentine and Castor Oil — Take two drachms of turpentine, 
and six or eight drachms of castor oil ; mix them well together, for a dose. 
This combination is proper, when a prompt action on the bowels is re 
quired, as in affections of the brain, &c. 

Purging Draught — Take of Epsom salt, Glauber's salt, each two 
drachms; mint-water, an ounce and a half; antimonial wine, forty or fifty 
drops ; tincture of senna, two drachms. Mix. 

This is a very valuable and effectual purgative for all acute diseases, and 
most common purposes. If a purgative which will operate quickly and 
actively be required, the following will be found useful : 

Compound Senna Tea — Take of senna leaves, one ounce ; manna, hall 
an ounce ; cream of tartar, five drachms; cinnamon bark, half an ounces 
boiling water, a pint and a half. Infuse for two hours. The dose is a 
wineglassful every two or three hours. 

Pills of Rhubarb and Soap. — Take of powdered rhubarb, one drachm , 
white soap, ten grains; with water enough to mix into a soft mass. Di- 
vide into fifteen pills ; dose, two to four at bed time, for a gentle pur- 
gative. 

Laxative Powder. — Take of powdered rhubarb, twenty grains ; calcined 
magnesia, ten grains; essence of cinnamon, ten drops. Mix. A good 
mixture in acidity of the stomach or bowels, when a gentle purgative is 
needed. 

EMETICS, or Medicines that produce Vomiting. 

Ipecac, the powder ; dose, from fifteen to twenty grains. Put the ipe- 
cac in half pint of warm water, and let the patient take about four table- 
spoonfuls every five minutes, until vomiting is produced. Drinking freely 
of warm water, during the intervals, assists the effects of the medicines 
For children, one-fourth to two-thirds the dose, according to the age. 

Syrup of Ipecac, for children, is the best: half a teaspoonful every ten 
or twenty minutes, or oftener, if necessary, will have the desired effect. 

Wine of Ipecac, is given in doses from one to two teaspoonfuls, every 
half hour. 

Tarter Emetic. — Dose, dissolve two grains in four ounces of hot water \ 
a tablespoonful every ten minutes. It is not safe for children. 

Antimonial Wine — Two teaspoonfuls every ten minutes 

White Vitriol, (Sulphate of Zinc.)— Thirty grains dissolved in watet, 
tn cases where a speedy emetic is wanted, as in poisoning. 

Tickling the throat with a feather, will often produce vomiting at one*, 
in cases of poisoning, &c. 

Ground Mustard— A teaspoonful or two mixed in a gill of water, it ar 
active emetic in cases requiring prompt vomiting. 



ClcMSijlcation of Medicine*. 393 

LAXATIVE AND PURGATIVE INJECTIONS. 
For Grown Persons, 

Take of common salt, a dessert-spoonful ; tepid water, or water-gruel, • 
pint ; add a tablespoonful of sweet oil, or melted butter. 

A more active injection is made as follows : 

Take a strong infusion (or tea) of senna, a pint ; Glauber's salt, or Ep> 
iom salt, an ounce and a half. Sometimes, to increase the purgativs 
effect, a spoonful of oil of turpentine may be added. 

For Infants and Children, 

Injections may be made in the same way as for adults, diminishing the 
quantity of fluid, and keeping out a portion of the stimulating ingredient, 
whether salts or senna 

CARMINATIVES, or Medicines to Expel Wind, 
For Grown Persons, 

Ten or fifteen drops of the Essence of Peppermint, on a small bit of 
•agar. 

Assafcetida Pills, three at bed-time. 

Carminative Injection. — Take of infusion of senna, eight ounces ; dis- 
solve in this infusion, assafcetida, a teaspoonful and a half ; add pepper- 
mint water, one ounce. To be mixed together, and thrown up, pretty 
warm. 

For Infants and Children, 

Sweetened Cinnamon or Aniseed Water, one or two teaspoonfuls every 
half hour. 

Essence of Peppermint, from one to three drops, every half hour. A 
tea made of caraway, dill or fennel seeds ; or calamus root, chewed and 
swallowed, as well as hartshorn, 10 drops in water, are all good medicines 
of this class. 

DIURETICS, or Medicines that promote the flow of Urine. 
For Grown Persons, 

Take of cream of tartar, one drachm; borax, half a drachm. Mix. 
Dissolve in three ounces of tepid water ; this quantity to be taken three 
times a day. 

Sweet Spirits of Nitre — A teaspoonful in warm water, four or five times 
a day. 

Acetate of Potass — From twenty grains to a drachm three times a day. 

Nitrate #f Potass, (saltpetre) — Thirty to sixty grains in a pint of gruel 
This quantity to be used as a common drink in the twenty-four hours. 

Oil of Juniper — Four drops on white sugar, three times a day. 

Squill— One grain in powder, mixed with powdered cinnamon, three 
times a day ; or, two grains of squill, with ten grains of powdered nitre, 
to be mixed in sugar and water, or molasses, and repeated twice 01 three 
times a day. 

Diuretic Mixture. — Take of sweet spirits of nitre, one ounce; tmcture 
of squill, two drachms. Mix. Dose, a teaspoonful five or six times a day, 
given in a teacupful of the following, namely : juniper berries, bruised. 



B94 Classification of Medicines. 

one ounce ; and cream of tartar, half an ounce ; infused in a pint ol boll 
tag water. 

Infusion of Juniper Berries in Cider. — Take of bruised juniper berrie^ 
mustard seed, and ginger root, of each half an ounce ; grated horse-rad- 
ish and parsley root, of each one ounce ; and infuse them in a quart of 
hard cider. The dose is a wineglassful, three or four times a day. Thii 
infusion has been found useful in oases of general dropsy occurring in pa- 
tients very much debilitated and unconnected with inflammation, of 
disorganization of any internal organ. When fever or inflammaJon ii 
present, it would be improper. 

Carbonate of Potash — Half drachm in a pint of water. Dose, two 
tablespoonfuls every two hours. 

Cream Tartar — One ounce in a gallon of water ; to be drank during the 
twenty-four hours. 

Oil of Turpentine— One to two teaspoonfuls, three times a day. 

For Infants and Children. 

Nitrate of Potass, (saltpetre) one drachm ; water, eight ounces. Dis- 
solve, and sweeten with refined sugar. Dose, from a teaspoonful to a 
tablespoonful every three hours, till the water flows freely. 

Sweet Spirits of Nitre, one teaspoonful ; water, three ounces. To be 
mixed together, and a little syrup added. 

A tablespoonful every two hours. 

A drink made by dissolving a drachm of cream of tartar in a quart of 
boiling water, and sweetening it with sugar, may be used, to increase the 
arine. 

DIAPHORETICS, or Medicines to produce Perspiration 

or Sweating. 

For Grown Persons. 

By regulating the doses of the following medicines, and the drink of the 
patient, as also the quantity of his bed-clothes, we can produce a perspira- 
tion more or less copious. 

Antimonial Medicines are excellent diaphoretics. A grain of tartar 
emetic may be dissolved in five ounces of hot water ; and a tablespoonful 
of this solution given every two hours, will generally occasion perspiration. 
Or James's powder, three or four grains, in honey, jelly, or marmalade, 
every three hours. 

Diaphoretic fever powder. — Take of nitre, powdered, one drachm ; tartar 
emetic, one grain ; gum-arabic, half a drachm ; for twelve powders ; oni 
to be taken every three hours. 

A mixture of narcotic and emetic medicines, makes an excellent sudo- 
rific or sweating medicine. Such are Dover's powder, and the diaphoretic 
draught, made by adding thirty drops of laudanum to forty drops of anti- 
monial wine, and the same quantity of sweet spirits of nitre, to be takeu 
in an ounce of cinnamon or peppermint water. 

These combinations of opium should be avoided when the skin is verj 
hot and dry ; but they may be used in rheumatism and other feverisL dis 
orders, after the violent excitement is in some degree removed. 

Camphor- -Two grains of camphor reduced to powder by the help of t 
little alcohol or whisky, and half a grain of opium, made into a bolus ; to 
be repeated only once or twice at the interval of four hours. 

Diluted Acetate of Ammonia, (Spirit of Mindererus)- From two draohm 



Classification of Medicines. 196 

10 half sd ounce, in an equal quantity of water, every three hours. (8p|. 
fit of mindererus can be made by dissolving a teaspoonful of carbonate of 
ammonia in a teacupful of vinegar.) 

Saline Mixture. — Take of the fresh jjice of lemons, one ounce and 9 
half ; and of the sub-carbonate of potassa, or chlorate of potash, twenty 
grains; then add, of white sugar, one or two drachms; of tartar emetic, 
one grain ; and of pure water, an ounce and a half, and the same quantity 
of cinnamon water. Dose, a tablespoonful every two hours. This is an 
•xoellent prescription in most cases of fever. 

Diminished doses of Ipecac may a^so be used to promote perspiration. 

For Infants and Children, 

Antimonial Wine — From four to ten drops, in a teaspoonful of tepid 
vater, every two hours. 

Take of tartaric acid, one drachm ; carbonate of potass, four scruples. 
Dissolve each of them separately in an ounce of water, add them together, 
and, when the effervescence is over, add, syrnp, two drachms ; cinnamon 
water, half an ounce ; water, four ounces. 

Dose, a teaspoonful every two hours. 

Diaphoretic Mixture. — Take of sweet spirits of nitre, four drachms; 
water, two ounces ; cinnamon water, two ounces ; sugar, four drachms ; 
tartar emetic, one grain. Mix. Dose, a teaspoonful every three or four 
hours. 

A tea made of Virginia snake root, or pleurisy root, or boneset, is good 
for sweating. 

EXPECTORANTS, 
To bring Phlegm from the Lungs. 

Squill. — The powder of the dried root, one grain night and morning, 
made into pills with powdered cinnamon and ginger. Or vinegar of squill, 
a small teaspoonful, with simple syrup, in a litle peppermint water three 
times a day. 

Ipecac. — One grain three times a day, made into lozenges. 

Sulphate of Zinc. — One grain, with powdered ginger, twice a day. 

The Steam of Hot Water and Bitter Herbs, such as hoarehound, sage, &e. # 
inhaled into the lungs. 

Expectorant Mixture. — Take of mucilage of gum arabic, four ounces, 
■yrup of squill, four drachms ; tarter emetic, two grains ; sweet spirits of 
nitre, three drachms. Mix. A teaspoonful to be taken every three hours. 

Brown Mixture. — Take of the powdered extract of liquorice and of 
powdered gum arabic, of each two drachma ; dissolve in four ounces of 
warm water; then add sweet spirits of nitre, two drachms; tartar emetic, 
one grain ; and laudanum, forty to sixty drops, or paregoric, one tea- 
•poonful. Mix. The dose is a table-spoonful every four hours. This ii 
a good, prescription in cases of catarrh, towards the decline of the disease, 
when a troublesome cough still remains. 

Expectorant Pills. — Take of extract of henbane, eight grains ; extract o 
belladonna, one grain ; powdered Ipecac, four grains ; for eight pills 
Dose, one every three hours. 



306 Classification of Medicines, 

ABSORBENT MEDICINES, 

Or Correctors of Acidity in the Stomach, and of Heartburn. 
For Grown Persons. 

Carbonate of Potass, or carbonate of soda, from ten to thirty grains, te 
water. 

Prepared Chalk, when the bowels are loose ; from twenty grains to tw« 
drachms in cinnamon water, or milk. 

Calcined Magnesia, when the bowels are costive ; to be taken in the same 
way. The above two articles meeting with an acid in the stomach form % 
neutral salt : that with chalk is binding ; with magnesia laxative. 

Lime Water. — A small wine-glassful, with three table-spoonfuls of milk, 
three times a day. 

For Infants and Children, 

Calcined Magnesia, or Prepared Chalk, miy be given in milk or any 
liquid, or mixed with the food, in doses of from three to ten grains. 

ANOJD ynes, 

Medicines to allay Pain, and procure Sleep. 
For Grown Persons, 

Opium. — One or two grains. It can be made into a pill without any 
addition. Opiate pills may be made also by taking equal weights of opium 
and powdered cinnamon, and forming them into a mass with simple syrup. 
This mass may be divided, so as to make the pills to contain each one graia 
of opium. 

Paregoric may be given as an anodyne ; half to one teaspoonftil. 

Anodyne Draught. — Take of laudanum, thirty drops ; cinnamon water, 
one ounce. To be sweetened with dissolved jelly or syrup, and taken at 
once. 

Or, sulphate of morphia, two grains; cinnamon water, four ounces 
sugar, one drachm. Dose, a teaspoonful every three hours. 

Anodyne Injection. — To one ounce of olive oil, and three of thin made 
starch, add thirty, forty, or sixty drops of laudanum, and mix the whole 
well together. 

This injection is particularly useful in cases in which there is great 
irritation about the lower part of the bowel, bladder or urinary passages, 
and in dysentery and diarrhoea, after proper evacuations. The reliei 
Obtained is sometimes almost instantaneous. 

When opium binds the bowels too much, Henbane in extract or tinctura 
aay be used in larger doses than opium ; three grains of the extract, or a 
drachm of the tincture. A strong tea made of hops, a few spoonfuls every 
two hours, is also good. 

For Infants and Children, 

Opiates are so hazardous, that we feel reluctant to sanction the use of 
any one of them internally ; but from three to ten drops of paregoric, 
according to age, given at bed time, may be considered safe. 

For external use, Anodyne Balsam, or the tincture of soap with opuna\ 
rubbed on the belly or along the spine, in the quantity of a table-spoonful 
In many cases allays pain very effectually. 



Classification of Medicines. 397 

ASTB INGENTS, 

Or Medicines to lessen Discharges of Fluidi, 
For Grown Persons, 

In Looseness of tie Bowels ; after being sure that they are cleared of til 

rritating matter, as much as possible. 

Astringent Drops. — Take of tincture of rhubarb, two teaspoonfdls ; laud* 
icm, one teaspoonful. Mix them together. Thirty-six drops to be takea 
four times a day in a little water. 

Chalk Mixture. — Take of prepared ehalk, one ounce ; refined sugar, hall 
ah ounce ; mucilage of gum arabic, two ounces. Mix together, and then 
gradually add, of water, two pints and a half; cinnamon water, two ounces. 

Of this, a small cupful may be taken four times a day ; and if it be 
thought necessary to increase its astringent power, ten drops of laudanum, 
or half a teaspoonful of the tincture of kino, may be added to each dose. 

Astringents, in discharges of Blood from the Lungs or Womb. 
Infuse a handful of dried Red Rose Leaves in a quart of boiling water for 
half an hour. Strain off the liquor, and add of diluted sulphuric acid, 
thirty drops; simple syrup, two ounces. A table-spoonful to be taken 
every two hours, when necessary, during a discharge of blood. Other 
measures at th* same time being employed for the cure of the disease. 

Astringents, to be thrown into the Vagina for the cure of Whites. 

Thirty grains of White Vitriol dissolved in a pint of water. 

Or, take of oak bark, two ounces; water, two pints. Boil to one pint; 
to wnich, when strained, add one drachm of alum. Inject half a pint up 
the parts three times a day. 

ASTRINGENTS, to check Looseness of Children. 

Astringent Mixture. — Take of best Turkey rhubarb, twenty grains ; pre- 
pared chalk, one drachm ; Dover's powder, ten grains ; simple cinnamon water, 
naif an ounce ; spring water, two ounces and a half. Mix them careMly. 

Dose, from one to two teaspoonfuls every six hours, This is found 
particularly useful in some cases of habitual looseness. 

Stronger Astringent Mixture. — Take of tincture of catechu, two drachms ; 
prepared chalk, half an ounce ; simple cinnamon water, one ounce ; spring 
water, five ounces. Mix them. 

Dose, from two teaspoonfuls to a table-spoonful every three or foul 
aours. This may be rendered still more powerful in checking debilitating 
looseness, by the addition of a small proportion of laudanum to each dose. 

For Grown Persons. 

Nut Galls in powder. The dose from ten to twenty grains. 

Black-Berry Root. That of the running brier, called Dew Berry, is the 
best. An ounce of it bruised and put in a pint of boiling water. Th 
dose about half a cupful, three or four times a day. 

Alum. Dose five to ten grains : also small doses of rhubarb. 

White Oak and Chestnut Bark % in substance or strong decoction, ar 
powerful astringents. 

Gum Kino and Catechu come under this head. The dose of either if 
from five to ten grains. 



393 Classification of Medicin9». 

Lime Water, particularly when acid exists in the stomach, has a slmila 
effect. The dose is a half teacupful, with an equal quantity of milk. 

Common Salt. A table-spoonful has been recommended to stop bleed 
jog of the lungs. The dose may be repeated. 

Charcoal in powder, in small doses, has an astringent effect upon tht 
bowels : also when applied to bleeding parts — as the nose, gums, etc. 

Cold Water is ranked amongst the most useful of astringents. It is tk 
application for local bleedings. 

TO CHECK VOMITING. 

The Effervescing Draughts of Soda and Tartaric Acid. 

Toast water taken cold in table- spoonful doses every half hour. 
An Opium or Mustard Plaster to the pit of the stomach. 
Lime water, a teaspoonful, with the same quantity of milk every tvo 
hoars. 

TONICS AND BITTERS. 

For Strengthening the System. 

Peruvian Baric. A teaspoonful three times a. day, in milk or port 
wine. 

Sulphate of Quinia, one to two grains before each meal. 

The following is a good way of administering the quinine : Take of sul- 
phate of quinia, ten grains; elixir of vitriol, half a drachm ; white sugar, 
four spoonfuls; water, four ounces. Dose, a teaspoonful. 

Dogwood Baric and Bark, of the Wild Cherry tree, reduced to fine pow 
der, and taken in doses of thirty or forty grains, or drank in strong tea, 
will be found nearly as good as the Peruvian bark. 

Angustura Baric, in doses from five to twenty grains, is by some es- 
teemed equal to the Peruvian. 

Columbo Root, in doses from twenty to thirty grains, or taken infused 
in water or wine — an ounce to the quart — is a powerful t!>nic, in doses of 
two tablespoon fuls three times a day. 

Gentian Root and Quassia are among the strongest bitters. A very com- 
mon bitter tincture is made of two ounces of gentian, one ounce of orange- 
peel, and half an ounce of cascarilla bark in a quart of spirit or wine ; and 
it is a tonic. Dose, one tablespoonful three times a day. 

Bitters, in general give tone to the system ; and among those most 
used are — 

Chamomile Flowers, Hops, Virginia Snake Root, Horehound, and Worm* 
vood, separately, or in combination made in strong tea, or added to wine 
or spirit, make agreeable and mild bitters. 

Charcoal in powder, in doses of a teaspoonful once in two hours, has 
been found a valuable tonic. 

^ Nitric Acid. This is a most powerful tonic ; especially in chronic affec- 
tions of the liver, etc. It is generally given a teaspoonful in the course of 
a day, diluted in a quart or more of water, and sweetened to render it 
palatable. To be drank through a quill, to save the teeth. 

Iron has long been considered as a tonic, not only when in substance 
but when in solution, as in the state of chalybeate waters. The filings of 
iron were once much used ; but a better form is the Rust of Iron, in dosei 
from five to ten grains three times a day. 

Green Vitriol. Dose from two to four grains, twice a day. 



Classification of Medicines. 399 

Tincture of 8tt<sl. Dose from fifteen to thirty drops, three timet 

day. 

Ohalyheate Waters owe their strengthening qualities to iron, which is 
dissolved by the agency of fixed air. By putting a few grains of the rust 
of iron in a bottle, and having it filled with the common Soda Water as it 
is called, as val lable a chalybeate drink may be had as from any of our 
■prings, to whioh so many resort. 

Ionics are rot to be given in high fevers, and the following rules should 
be obsorved in recovering from sickness : 

Let the die*, of the patient be accommodated to the state of the system* 
After recovering from violent disease — it should at first consist of the 
lightest vegetable matter, as rice, tapioca, arrow-root, and sago, also Irish 
potatoes. Then eggs, oysters, wild fowl, poultry, and finally beef and 
mutton, generally selecting the articles most agreeable. The patient 
should eat often and in small quantities, and solid food is generally pre- 
ferable, and should be prepared as plain as possible. 

WORM MEDIC INES. 

Except Rochelle, Epsom or Glauber Salts, almost any purgative may be 
used to expel worms. 

Take of calomel, four grains; powdered jalap, four grains; powdered 
aloes, three grains. To be mixed together and given in jelly, honey, or 
conserve of roses, at bed time, followed next morning by a dose of castor 
oil. 

Five grains of aloes, with four of soda, taken at bed time, and followed 
next morning by a tea-cupful of strong infusion of senna-tea. 

A teaspoonfal of common salt, taken in the morning, when the stomach is 
empty, will often expel worms. 

Two or three cloves of garlic may be swallowed in the morning for a 
length of time, or three grains of assqfectida made into a pill. 

Injections made of senna-tea, with a teaspoonful of tincture of aloes, 
may be thrown up the bowels, to destroy the small white worms. 

A teaspoonful of oil of turpentine, given in syrup, will, in many cases, 
carry off the tape-worm. 

Pink-Root. — The dose is from five to ten grains of the powder, or an 
ounce of it boiled in a quart of water, of which one or two tablespoonful§ 
may be given every two or three hours. It is to be followed by a brisk 
purgative after it has been taken three or four days. 

Worm-Sicd Oil, extracted from the seed of the Jerusalem oak, in dose* 
of eight or ten drops, taken morning and night for three days, followed by 
a purgative. 

EYE- WATERS. 

When there is much inflammation, decoction or tea of quince seeds, or tn- 
fusion of the pith of sassafras, applied every three hoTirs. When the inflam- 
mation is abated, twelve grains of the sulphate of zinc, dissolved in sii 
ounces of rose-water, applied every three hours. 

Six to ten grains of acetate of zinc, in four ounces of rose water, applied 
eyery three hourt. 

Twelve grains of sugar of lead, dissolved in six ounces of spring water, 
with the addition of a tablespoonful of distilled vinegar, is a stimulating 
•ye- water. 

The quantity of sugar of lead nlay be increased if necessary. 



400 Classification of Medicines. 



GARGLES. 

A good domestic gargle for sore throats is made by using vinegar, dilated 
with warm water, and sweetened with honey or sugar. 

Infusion of red rose leaves, acidulated with vinegar. 

Or a gargle may be made with port wine and a little vinegar, or strong 
sage tea, with the addition of alum and honey. 

Gargles should always be of such a degree of sharpness as to cane* • 
temporary smarting of the throat. 



STIMULANTS. 

These are medicines which excite a general action ovei the whole sys- 
tem, but of short duration, which is exemplified in the effects of spirituous 
liquors. A rule respecting them, when they are required, is that they are 
to be frequently renewed, the quantity gradually increased, and the kind 
changed. The most common and the best are our much-abused intoxicat- 
ing liquors in the various shapes of spirituous liquors, wines, porter, ale, 
cider, &c. Those which are considered of the strictly medicinal kind are : 

Spirit or Oil of Turpentine. — The dose is thirty to sixty drops. 

Sulpliuric Ether. — Dose from one to three teaspoonfuls, mixed in half a 
tea-cup of water. 

Spirit of Lavender. — Dose about a teaspoonful. 

Hartshorn, called Vohtile Salts. — Dose from ten to fifteen grains, made 
into a pill with syrup. Of the same nature is 

Spirits of Hartshorn. — Dose from one to two teaspoonfuls. 

Taas of Hops and orr garden herbs, as well as of those imported, are 
also of this class. 

Garlic and Onions are stimulants as commonly used. 

Opium, and its preparations of Laudanum and Paregoric, in small dosea, 
are equal in stimulating power to spirituous liquors. 

Blisters are often used to stimulate the whole system. 

Articles to irritate the nose, as volatile alkali, hartshorn, snuff, assafoetidaj 
burnt feathers, and any thing very offensive, are sometimes properly usea 
to rouse a momentary action. Sudden burning, and irritating the skin by 
whipping, have often done good in rousing the system. 

All the stomachics and cordials, in common use, particularly the various 
essential oils of peppermint, cinnamon, &c. ; all our spices, as pepper, gin- 
ger, &c, are often used to rouse the whole system to action, ana with very 
good effects. 

A X T I-S r A S M O J> I C S 

Abe those stimulants which are supposed to remove spasm, cr a kind of 
eramp in parts of the body. Of these the most remarkable are — 

Opium and its preparations in large doses, depending on the urgency of 
Ike case. 

Tincture of Valerian, and Tincture of Hyoscyamus ; dose, one half to 
two teaspoonfuls, three times a day. 

Sulphuric Ether — Dose, a small tablespoonful. 

Aseafostida — Dose, in substance, eight or ten grains : in tincture, three 
er four teaspoonfuls. 

Mush— From ten to twenty grains. 

Eeeence of Peppermint — A teaspoonful in a glass of cold water 



Classification of Medicines. 401 

DEMULCENTS 

Ark medicines supposed to sheathe or cover parts in a state of irritation j 
as the mouth, throat, stomach and bowels, in a state of increased sen- 
sibility or soreness. Of this class are all the articles which are commonly 
known to make a mucilage with water, as gum-arabic, and the gums of 
our orchard trees ; teas of elm bark ; of the root ©f the cat tail of our 
marshes ; flax, melon, and quince seed, &c. &c. Oils of the mild kind 
hare a similar effect ; especially olive oil. 

LOCAL IRRITATING REMEDIES. 

Notwithstanding the term applied to this class of medicines, some of 
them produce a powerful effect on the whole system ; not the least of 
which may be ranked — 

Spanish Flies, or the potatoe fly of this oountry, universally used for 
exciting blisters. The fly should be very finely powdered, and mixed with 
equal quantities of beeswax and tallow, melted together, or with tallow 
alone ; and is to be spread on soft leather or thick linen — or the plaster 
may be spread with the tallow, and the flies sprinkled on it. In cases 
where it would be injurious for the flies to adhere to the skin, the plaster 
may be covered with thin gauze. An ounce of flies in a quart ol spirit, 
forms a good application to irritate the skin. 

Mustard Seed, reduced to powder, and mixed up into a paste with vine 
gar, is also a common mode of irritating the skin. 

Nitric-Acid — Two parts with one of water, spread by a feather on the 
part, speedily destroys the skin, which can be rubbed off in a few minutes, 
ai.d the raw part kept discharging by irritating ointments. 

Burgundy Pitch, spread on leather, and worn on the skin, makes a mo- 
derately stimulating plaster ; improved by sprinkling on it a little of the 
dust of the Spanish fly. 

Volatile Liniment, made by mixing equal quantities of spirit of harts- 
horn and olive oil. 

Volatile Alkali, or spirits of hartshorn, is frequently used alone, to ex- 
cite irritation on the surface. 

Spirit of Turpentine, Spirit of Camphor, Bed Pepper in Spirit, each 
makes valuable local irritants, and they are often used to relieve rheumatic 
and other deep-seated pains. 

Tartar Emetic, twenty grains in a gill of water, with half a gill of tinc- 
ture of Spanish flies ; and common salt, with or without red pepper, an- 
swers a similar purpose. 

OINTMENTS. 

Those most generally used for common sores are, 

Simple Ointment. It is designed merely to sheathe the parts and ex 
tlnde the air. It is generally made by melting half a pint of olive oil with 
&nr ounces of beeswax. But suet alone, or mixed with equal quantities 
of hog's lard, will answer equally well. 

Lead Ointment. This is used for sores of an inflammatory nature. 14 
is made by pounding one drachm of sugar of lead very fine, and intimatbijr 
nibbing it u.p with five or six ounces of hog's lard. 

Basilicon, or Yellow Resin Ointment. This is used in common sores, 
requiring a little excitement. It is made by melting one ounce of beeswax 
and the same quantity of yellow resin, with an ounce and a half of hog's 
«ar(L 



40S Miscellaneous Jtecipes, 

Bed Precipitate Ointment, made by rubbing up one drachm of 
dered precipitate with one ounce of hog's lard. 

Tar Ointment. Valuable for affections of the skin and scald head; 
made by melting together equal quantities of tar and suet. 

C A USTICS. 

These are frequently necessary to destroy the fungous of sores or proud 
flesh, as it is vulgarly termed ; and to stimulate them to greater action 
That most commonly used is 

Burnt Alum. This is common alum deprived of its water, by keeping 
it on a hot iron until it ceases to boil ; it is then powdered and sprinkled 
on the sores. Powdered rhubarb is a good substitute. 

Lunar Caustic. This article, obtained from the druggists, Is most used 
by surgeons. Its application is very simple, the edge of it slightly moist- 
ened, the sores are to be gently touched with it. 

Nitric Acid. When diluted freely with water, it is very commonly 
applied as a wash to destroy the worms or maggots of sores in warm 
weather. 



MISCELLANEOUS RECITES. 

Antimonial Wine. — To make this, put twenty grains of powdered tartai 
emetic in ten fluid ounces of sherry wine, and shake till dissolved : for 
dose, see tabular list of Medicines. 

Hose Water. — Mix five drops of otto of rose with a tablespoonful of 
powdered white sugar, rubbing well until all the oil has been taken up in 
the sugar ; then dissolve the sugar in one quart of cold water, and strain 
through muslin. 

Spermaceti Cerate. — Melt one ounce of spermaceti, three of white wax, 
and six ounces of sweet oil, or lard, in a vessel over a slow fire, mixing 
thoroughly. This makes a good healing application to sores, ulcers, 
burns. &c. 

Resin Cerate, (or Basilicon Ointment.) — Kesin, five ounces ; lard, eight 
ounces ; yellow wax, two ounces. Melt and mix together, and while hot 
it may be strained through a coarse cloth or sieve, used the same as the 
above. 

Compound Bezin Cerate. — Kesin, suet, wax, of each four ounces ; tur- 
pentine, two ounces; flax-seed oil, two ounces; melt and mix together. 
This is more stimulating than the two previously given, and is better for 
*ld sores and ulcers sometimes, where they have become chronic. 

Yeast Poultice, is made by mixing one pound of wheat flour with on« 
pint of yeast, exposing to a gentle heat until it begins to rise ; it is then 
applied. 

Simple Cerate, is made by melting four ounces of lard and two ounces 
•f white wax together ; it is a good healing application to simple sorea, 
cracked lips, chapped hands, &c. 

Chareoal Poultice. — A poultice made from half a pound of oatmeal 
thickened with water, with the addition of two ounces of finely powdered 
charcoal, is employed in cases of mortification, to destroy the fetor arising 
from the dead portions of flesh and offensive discharges. 

Leeches. — These are applied to various parts of the body, to draw blooa 
for the cure of disease. 

A leech attaches itself to any substance to which it wishes to fix, by aa 
apparatus, constructed on the principle of a leather-sucker, or air-puinp, 



Miscellaneous ftecvpes. 40B 

*2»ioh it has at both ends ; the one at the head being like a horse-shoe, 
with a triangular mouth in the centre, and that at the other end being 
•ircular. When they fix on the body, they inflict a small wound of three 
Kttle flaps, from which they suck blood until they are gorged, or till they 
•re forced to quit their hold ; which is best done by sprinkling on them a 
little salt. 

Enemas, or Injections. — For flatulent Colic. Assafoetida, two drachma, 
and thin gruel, or starch, ten ounces, well mixed together. 

Purgative Enema. — Senna leaves, three ounces; glauber salts, om 
oniuse; and boiling water, one pint; when cold, strain. 

Common Enema. — Warm water, one pint; sweet oil and molasses, of 
each one ounce ; common salt, one drachm. 

Anodyne Enema. — To relieve pain in the lower part of the bowels, con- 
stant straining, as at stool, or profuse diarrhoea. Thin starch, half a pmt ; 
olive oil, one ounce ; opium, from a half to two or three grains for an 
adult; smaller doses, in proportion, for a child. 

Warming Plaster. — This plaster forms an excellent local irritant, in 
cases in which the action is wished to be kept up for a long time, without 
exciting a blister. It is composed of Burgundy pitch and Spanish-fly ce- 
rate, seven parts of the first and one of the latter, melted together, and 
then spread on leather. 

Warners Cordial. — This is an excellent purgative in persons troubled 
with a weak stomach, flatulence, or tendency to cramps of the bowels. It 
is composed of an ounce of rhubarb, two drachms senna, a drachm of cori- 
ander, and the same quantity of fennel-seed bruised ; red saunders, two 
drachms ; saffron and liquorice, of each, half a drachm ; stoned raisins, 
half a pound, and diluted alcohol or whisky, three pints ; to be steeped 
together for two weeks, then strained through paper : dose, half an ounce 
or an ounce. 

Turner's Cerate. — This cerate is a very useful dressing to produce the 
healing of simple ulcers, excoriations, slight burns, blisters, &c. It is made 
by melting together half a pound of yellow wax and two pounds of lard, 
and stirring into the mixture, while fluid, half a pound of prepared car- 
bonate of zinc 

Kentish Ointment. — This ointment, made by mixing together two ounce! " 
•f basilicon ointment, and two drachms of turpentine, has long been cele- 
brated as a dressing for burns and scalds. Care should be taken to pre- 
vent its contact with the sound skin, surrounding the burn or scald ; for 
though a soothing application to the latter, in the surrounding parts it will 
be very apt to produce severe inflammation. 

Gregory"** Powder. — This is a useful laxative powder, composed of equal 
parts of calcined magnesia, powdered rhubarb, and ginger ; it was a fa- 
vorite prescription of the late Dr. Gregory, of Edinburgh. He considered 
it possessing various good properties, the magnesia correcting acidity, the 
rhubarb acting as a tonic and laxative, and the ginger being a good aro- 
matic for the stomach, and preventing griping of the bowels. The dose 
of this compound powder is one or two drachms, or a heaped teaspooiiful ; 
and it may be taken in water, in gruel, milk, or any vehicle, that may be 
most convenient. It generally operates easily and effectually, and may ba 
taken at any time of the day. The dose may be repeated after an interval 
of four or six hours, if the first dose does not produce its proper effeot. 
Sometimes it may be advisable, especially for children, to omit the ginger, 
and to give simply a mixture of rhubarb and magnesia, in the dose of a 
•mall teaspoonful. 

Effervescing Draught.— The effervescing draught is made by dissolvinf 



404 Miscellaneous Recipes, 

% drachm, or a drachm and a half of carbonate of soda, of potash, of d 
ammonia, in an ounce of water, and mixing with this an ounce of lemon* 
juice, with a little water and sugar; or if lemon-juice cannot be procured. 
dissolving a drachm of crystallized citric or tartaric acid in an ounce of 
water, and adding this to the alkaline solution. The two solutions when 
they meet, occasion, by their mutual action, an effervescence, in con« 
sequence of the escape of the carbonic acid; and should be swallowed 
while this action is going on. The medicinal virtues of the effervescing 
draught are to check vomiting, and to determine the blood to the skin; 
hence it is very useful in a variety of diseases, especially feverish and dye* 
peptic complaints. The materials for making the effervescing draught are 
kept in the shops under the name of soda powders, and directions are given 
for their use. They are thought to give relief in the symptoms of indiges- 
tion which follow over-indulgence in eating or drinking. 

Coxe's Hive Syrup. — The hive syrup is made by boiling squill and seneca 
roots, of each four ounces, in four pints of water, until the whole is reduced 
one-half; the product is then to be strained, and two pints added of clari- 
fied honey, when it is to be boiled down to three pints, and forty-eight 
grains of tartar emetic, dissolved in a little water, added to the residue. 
The dose is from ten drops to a teaspoonful, according to the age of the 
patient. It is principally employed as an emetic and expectorant, in casei 
of croup, or in the lung and throat affections of children. 

Neutral Mixture. — This mixture is one of the moet agreeable, mild 
diaphoretic sweats we possess, in case of fever. It is made from recent 
lime juice, or lemon juice, one ounce and a half, saturated with subcar- 
bonate of potash, with the addition of a drachm or two of white sugar, and 
three ounces of pure water, or mint-water. The dose is a table-spoonful 
every two or three hours. Its powers are decidedly augmented by the 
addition of half a grain of tartar emetic to the mixture; or when this is not 
thought advisable, by adding a drachm or two of sweet spirits of nitre. 

Lenitive Electuary. — This is a very gentle and agreeable laxative in cases 
of simple costiveness. It is made by rubbing together in a mortar an 
ounce of senna leaves, and half an ounce of coriander seeds ; then sifting 
ten ounces of the powder through a sieve. The remainder, with the 
addition of three drachms of liquorice root, and two ounces of figs, is to 
be boiled in half a pint ©f water, until the whole is reduced to one-half. 
The liquor being pressed out and strained, is to be evaporated to one gill, 
and to this is to be added four ounces of sugar, and a syrup made in the 
usual manner by boiling ; one ounce of the pulp of prunes, the same 
quantity of tamarinds, and of senna, being well mixed together in a mortar, 
are to be added to the syrup, and the whole well combined with the sifted 
powder. The dose is a portion of the size of a nutmeg, or a table-spoonful. 

Aloeiir. Pills ; aloes and castile soap equal parts, made into five grain pills; 
for costiveness without any peculiarity of symptoms : two pills for a dcse 
at bed-time. 

La ly Webster's, or Lady Crespigny's Pills, are made of equal parts of 
rhubarb, aloes, and gum mastich. This last ingredient is not of much 
Tirtue in itself, but makes the solution of the others in the bowels gradual 
and equal. The dose of these pills, which have not received any particular 
name, is two or three, and the time for taking them is immediately before 
dinner ; they then mix with the food, prevent flatulency, and are usually 
found to operate next morning after breakfast. 

Disinfectant. — One- half pound of copperas dissolved in a bucket of water, 
poured down the sink three or four times, will completely destroy thfll 
offensive odor. As a disinfecting agent to scatter around premises affected 



List of Medicines /or a Medicine Chest. 405 

with any unpleasant odor, nothing is better than a mixture of four parti 
©f charcoal and copperas, by weight. All sorts of glass vessels and other 
ttensils maybe effectually cured from offensive smells by rinsing them 
with charcoal powder, after the grosser impurities have been scoured off 
with sand and soap. 

Blue Vitriol. As much of it as any given quantity of water can dissolve, 
!s frequently applied to old sores. 

Although many remedies have been mentioned, do not understand me 
%a recommending them for general use. Annexed is a list of such as we 
think ought to be in every family, at least in every neighborhood, espe- 
cially in country places, also for steamers, ships, etc. 

Your great dependence for the cure of disease should be on the wx>t% 
%imple means ; yo'i should give a decided preference to local, instead of 
general remedies, in most cases. 



A LIST OF MEDICINES FOB, A MEDICINE CHEST, 
For Ships, Families, etc. 

Ounces. 

Powdered Jalap % 

Powdered Rhubarb 1 

Magnesia, calcined 1 

Tartar Emetic % 

Powdered Ipecac % 

Powdered Aloes ... 1 

Laudanum 2 

Paregoric , 2 

Blistering Plaster 2 

Camphor 4 

Columbo Root 4 

Bugar Lead 1 

White Vitriol 1 

Blue Vitriol 1 

Powdered Nut Galls 1 

Spirit Nitre 4 

Ether Sulphuric 4 

Benna and Manna, each 8 

Flowers of Sulphur 8 

Chamomile Flowers 8 

Powdered Peruvian Bark 8 

Epsom Salts 2 pounds, and Cream 

of Tartar % pound. 
Oil of Turpentine, and Spirit of 

Hartshorn, each one bottle. 
(Jastor Oil, and Olive Oil, each 

one bottle. 

Essence of Peppermint 2 

Virginia Snake Root, % pound. 
Also a little Alum, Nitre, Borax 

and Basilicon Ointment. 

Tincture of Aloes 8 

Ajatimonial Wine 2 



Gum Ammoniac 4 

Gum Assafcetida 4 

Balsom of Peru 2 

Buchu Leaves 2 

Oardamon Seed 2 

Prepared Chalk .4 

Powdered Cinnamon Bark 4 

Essence of " ,2 

Extract of Colocynth 1 

Syrup of Squills 4 

'- Ipecac ...4 

" Rhubarb 4 

Dovers Powders 2 

Gum Guaiacum 1 

Carbonate of Ammonia, or Harts- 
horn 2 

Tincture of Iodine 2 

Gum Kino 1 

Compound Spirits of Lavender. . . .4 

Blue Mass, for " Blue Pills " 2 

Powdered Gum Myrrh 2 

Gum Opium, powdered, 2 drachms. 

Quassia 4 

Rochelle Salts 8 

Glauber Salts 4 

Oil of Worm Seed % 

Quinine 1 

Tincture of Hyoscyamus, or Hen- 
bane 4 

Tincture of Valerian 4 

Wine of Colchicum , 4 

Court Plaster, and Adhesive Plas- 
ter. 
Uva Uim Leaves .4 



406 



List of Medicines, 



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Their Doses and Uses 



407 





Whites, Diseases of Kidney, <fec. 

Diseases of Kidney, &c. 
( Rheumatism* recent colds, and 
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l Flatulence, Weakness of Sto- 
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The Movement Cure. 411 



THE MOVEMENT CUBE. 

This new curative treatment, so called, is nothing more than 
extending into minutiae tlie old principle of the " dumb-bells,' 
for giving greater strength to the muscles of the arms, and 
thereby taking off local irritation existing in the lungs, etc. ' 

While we can not admit the wonderful cures said to be per- 
lormed by this treatment, still we have seen cases greatly 
benefited by it, and under favorable circumstances is worthy 
a fair trial, as it can be done in the patient's own room, either 
alone, or in some cases having a friend to assist. 

The following is about the plainest description that can be 
given for popular use. 

Active Movements. — The purpose of an active movement, 
is to convey to, and concentrate upon a selected point, the 
nutrition and energies of the system. Such a movement may 
accomplish a two-fold purpose, that of supplying a part, and 
of relieving another part more or less distant. 

The mode of effecting this purpose is as follows : — The 
person to receive the application, is placed in an easy uncon- 
strained position, sitting, lying, half lying, kneeling, or any 
convenient position that will suitably adjust all parts of the 
body to the purpose. The body is fixed either by the hands 
of an assistant, or by means of apparatus, so as to prevent as 
much as possible any motion of all parts of the body, except 
the acting part. The patient is in some cases directed to 
move the free part in a particular direction, the effort to do so 
is resisted by the operator, with a force proportionate to the 
exertion made — very nicely graduated to the particular con 
dition of the part, and of the system at large. The resistance 
is not uniform, but varies according to the varying action of 
muscles, as perceived by the operator. In other cases the 
operator acts while the patient resists. The action is the 
game, but in one case the patient's acting muscles are short- 
ened ; in the other, lengthened. The operation is a sort of 
wrestle, in which a very limited portion of the organism is 
engaged. The motion must be much slower than the natural 
movement of the part engaged, which fact strongly fixes the 
attention and concentrates the will. The act is repeated two 
or three times with all the care and precision the operator can 
command, being cautious not to induce fatigue. A perfect 
reet in the lying position succeeds, of some ten or fifteen min- 
utes*. The changes of matter induced by the movement 
continue for that length of time, producing an afflux of power 
and nutritive material to the part, provided the patient 



412 

remains quiet. If, however, other actions he engaged in, it 
detracts from and diminishes the effect of the movement. If 
movements succeed each other rapiily, very much of th« 
peculiar effects are lost and the operation becomes to a certain 
extent gymnastic. 

The effect of a movement if properly applied and received, 
is to transmit the available force of the system, together with 
the conditions for its production to the acting part : this part 
receives what the whole system by the process is made to con- 
tribute. Thus a lax, weak, bloodless region is reinforced with 
fresh supplies contributed by the wiiole system. Every 
portion of the body is, in turn, and at proper intervals, sub- 
jected to similar operations. Such as the fingers, arms, legs, 
feet, etc. 

The great point is to commence these manipulations gradu* 
ally, and end in the same way ; and always follow the partial 
movements by thorough friction with the hand or a rough 
towel, and afterwards wrap up the part in a flannel cloth ; 
the under garments should always be flannel or woolen, also. 

FOISONS AND THEIR ANTIDOTES. 

The effects produced by many poisonous substances, take 
place with such promptness, that but little time is allowed for 
the exhibition of remedies, and the patient is often destroyed 
before the physician arrives ; whereas, had the proper treat- 
ment been immediately instituted, the fatal result might have 
been prevented. 

We shall in this place confine ourselves to a brief account 
of the leading effects produced by the introduction into the 
stomach of the various classes of poisons, the antidotes pro- 
posed for the principal articles of these classes, and the gene- 
ral medical treatment demanded in cases of poisoning. 

Poisons may be divided into the corrosive or acrid (which 
destroy the parts to which applied), the narcotic (or stupify- 
ing), and those acting both as corrosives and narcotics. 

The symptoms resulting from the first class, or acrid 
poisons, in addition to the particular taste of the article itself, 
are heat, irritation, or an extraordinary and sudden sensation 
of dryness, constriction (tightness) and roughness at the root 
of the tongue, and in the gullet ; these are succeeded by vio- 
lent efforts to vomit, and sharp pains in the stomach and 
bowels ; there is also great thirst, copious discharges by 
vomiting and stool, attended with much straining, and followed 
by hiccup ; a sense of constriction across the diaphragm (oi 
enest), and difficulty of breathing; pain is generally feli 



Poisons and their Antidotes. 413 

about the kidneys, followed by strangury (difficulty in urinat- 
ing), convulsions at length come on, or cramps of the hands, 
trembling of the limbs, extinction of the voice, repeated faint- 
ing:, cold sweats, and usually a hard and irregular pulse. 

The narcotic poisons produce the following effects : stupor, 
numbness, a great inclination to sleep, coldness and stiffnesi 
of the extremities, a cold sweat of an offensive or greasy na- 
tuie, swelling of the neck and face, protrusion of the eyes, 
with a haggard cast of countenance, thickening of the tongue, 
frequent vertigo (giddiness), impaired or depraved vision, 
delirium, general debility, palpitation of the heart, the pulse 
at first full and strong, afterwards becomes unequal and inter- 
mittent ; there is also paralysis of the lower extremities, re- 
traction of the lips, general swelling of the body, and swelling 
of the veins. At the conclusion of the disease slight convul- 
sions and pain are sometimes present. 

The effects of the narcoti co-acrid poisons, such as bella- 
donna, aconite, etc., are distinguished by a combination of 
several of the symptoms of both the foregoing classes. There 
is generally agitation, pain, acute cries, sometimes stupor, and 
convulsive motions of the muscles of the face, jaws and ex- 
tremities, and occasionally extreme stiffness of the limbs, and 
contraction of the muscles of the chest ; the eyes are red and 
starting from their sockets, the pupils frequently dilated ; 
there is often great insensibility to external impressions ; the 
mouth is f'-' M of foam ; the tongue and gums livid, or purple, 
withnaj^ct. Vomiting, frequent stools, etc. Often these symp- 
toms atta.*'-..m paroxysms, and between them the patient is 
left comparatively easy for a few moments. 

It might appear easy, from an attention to the symptoms 
we have recited, to distinguish the nature of the poisonous 
article under the effects of which the patient is laboring ; but 
nevertheless, nothing is generally more difficult. Substances 
very different in their nature, produce similar effects / as, for 
example, cantharides (Spanish flies), certain acrid vegetable 
substances and the caustic minerals. The difficulty is in- 
creased by the circumstance, that articles of ordinary food, 
perfectly innoxious in themselves, so far as regards any poison- 
ous property, in certain conditions of the stomach, and in cer- 
tain constitutions, when eaten, sometimes cause the most 
alarming symptoms. Roasted cheese, fish, crabs, lobsters, 
elams, mushroons, or even apples and cherries, have been 
known +o produce the most alarming symptoms and cause a 
suspicion of poison having been taken. A variety, also, ia 
frequently observed in the symptoms caused by the same 



414 Poisons and their Antidotes. 

poison in different persons. Many circumstances may con 
duce to this, such as 

The mode in which the article has been taken. When 
swallowed in a liquid form, the effects of a poison are gene- 
rally more prompt and marked than when it is taken in a 
solid state. 

If the article be taken on a full or empty stomach, its effect! 
will vary ; being much more rapid and certain in the latter 
case than in the first. 

The circumstance of vomiting occurring immediately, or 
not until after a considerable time, will produce a difference 
in the effects of the poison. In the former case the article 
may be rejected from the stomach before it has had time to 

Eroduce any injurious effects. Thus large doses of arsenic 
ave been taken intentionally as a poison, but in consequence 
of copious vomiting instantly following, the lives of the ind [- 
viduals have been preserved. 

To distinguish cases of poisoning from accidental affections 
of the stomach, produced by other causes, demands a judicious 
and cautious examination of every circumstance relative to 
the character and disposition of the patient ; the possibility of 
his having taken poison ; the article of which he had last eatt n 
or drank ; the vessel in which it had been contained ; tl e 
patient's own confession, if able to speak, &c. The diseas >s 
and symptoms most likely to be mistaken for the effects »f 
poisons, are probably those produced by idiosyncrasy (pecul - 
arity of constitution) and indigestion, and cases of sudden an 1 
unexpected illness. But the most striking cases of resemblanc e 
to the effects of poisons, probably occur in those who, aft* r 
being long accustomed to a particular species of food, for tL a 
fiist time use another kind. The treatment, in cases it 
poisoning, varies according to the individual articles takei =. 
As a general rule, in those cases in which the corrosive an J 
acrid poisons have been swallowed, the indications of cure an^ 

First, to endeavor to discharge the poison as quickly ai 
possible from the stomach. 

Then endeavor to destroy its poisonous properties, by the 
administration of antidotes. And afterwards to prevent 01 
subdue inflammation. 

The first indication is to be effected by the administration 
of an active emetic ; or, if vomiting has already occurred, ic 
general by the copious administration of diluent drinks ; or we 
-may attempt to remove the article from the stoujach, by as 
appropriate pump, if it can be had. 

Arsenic— This is an article very frequently made uae oi tl 



Poisons and their Antidotes. 411 

destroy life ; it is, also, often taken in mistake for other article*, 
■early resembling it in their external appearance, either of 
food or medicine. Arsenic may be taken in such quantity aa 
merely to produce disorder of the stomach and system, without 
necessarily destroying life ; or it may be taken in such quan-' 
tities as to produce death at a later period than twenty-four 
hours ; or, lastly, the quantity may be such as to induce death 
within twenty-four hours. When taken in the slightest 
portion, the symptoms produced by arsenic, are uneasiness at 
the stomach, with a sense of heat. When the dose is some- 
what greater, but not so great as to produce death, violent 
vomiting is commonly the first symptom ; although, in some 
instances, it is preceded by a sense of heat in the tongue and 
throat ; in other cases, these sensations are not felt during the 
whole course of the disease. When the vomiting is immediate, 
and the poison has been taken on a full stomach, the patient 
seems to owe his escape to the poison being discharged before 
it has had time to act. 

The next symptom claiming attention is purging, sometimes 
of blood ; but purging is less frequent in the slight cases, than 
in those where the degree of poisoning is greater. In the 
region of the stomach and bowels, pain is frequently felt : it is 
often, however, rather an unsup2?ortable uneasiness and 
oppression than pain, properly speaking. A sense of coldness, 
especially of the extremities, with cold sweats, seems nearly 
always to be present, with general paleness of the face and 
surface ; and in some cases languor, faintness and a tendency 
to sleep, In this degree of poison, convulsions are not fre- 
quently observed ; and thirst and fever are seldom present. 

In the second degree of poisoning from arsenic, when the 
patient lives a day or two, the first sensations are heat and 
thirst, vomiting, or inexpressible distress. The first is less 
frequent than the two others ; purging is not often present ; 
eonvulsion3 generally take place, however. In the third 
degree of poisoning, when death takes place within a few 
hours, the symptoms succeed each other rapidly, or occur at 
the same time; fainting a? d general debility almost invariably 
precede the vomiting, which occurs in most cases, as well aa 

E urging and griping, and death seems generally to proceed 
•cm exhaustion and rapid sinking of the vital powers. 
The indications in the troatment of poisoning from arsenic 
are : — To remove the poison. To protect the stomach and 
bowels from its effects ; and if the patient survive sufficiently 
long, to diminish inflammation. 
The removal of the poison is to be attempted by emetics of 



*16 Poisons and their Antidotes. 

sulphate of zinc, 01 if vomiting be present, by the aid \H 
diluent drinks, or a vegetable emetic (ipecac being the be> k) 
Tartar emetic slwuld never he administered. But when vom- 
iting does not quickly ensue from these means, the urgency ol 
the case demands a resort to more direct remedies. The 
stomach may be washed out by means ?f taking large drmia 
of sweetened water, and then causing vomiting by tickling the 
throat with a feather, &c; in this manner, a quantity of liquid 
is to be used, so as to dilute or suspend the poison, and by 
means of a stomach pump, when to be had, the whole may 
be withdrawn. By this procedure, we may, in many cases, 
succeed in saving the life of the patient. 

The second indication may be effected by means of milk, 
lime-water, soap suds, and drinks sweetened with sugar or 
honey. Fatty or oily substances are of doubtful utility. 

In a case reported by Joseph Hume, life was saved by 
administering freely, after vomiting had ceased, retching and 
pain, however, remaining, the carbonate of magnesia twenty 
grains, with twenty drops of laudanum, in water ; one or two 
cases subsequently reported are in favor of this practice. 

The third indication is to subdue inflammation by the same 
remedies as in ordinary inflammation of the stomach. 

For arsenic we unfortunately possess no antidote, strictly 
speaking. A preparation of iron has been vaunted, but it is 
of doubtful efficacy ; if either this or the stomach pump is 
used, it will be safest in medical hands. White arsenic is not 
the only preparation of the metal by which poisoning occurs ; 
the coloring substances known by the name of King s yellow 
and Scheele's green are both compounds of arsenic, and being 
frequently and culpably used in confectionery, have provea 
fatal. Similar symptoms occur and similar treatment is to be 
followed as after poisoning by white arsenic. Whether in 
poisoning by arsenic, or by any other agent, the vomited 
matters should always be carefully preserved in a vessel by 
themselves, for medical inspection ; and if there is any sus- 
picion of foul play, some responsible person should place them 
under lock and key. The chemist can detect the smallest 
amount of arsenic, even after years have elapsed. 

Corrosive Sublimate. — Besides the ordinary symptomg 
caused by corrosive poisons, the present article produces a 
peculiar sense of stricture and burning heat in the throat and 
gullet, increased when attempts are made to swahow ; there k 
also dysentery, bloody vomiting, and sometimes diminished or 
even suppressed secretion of urine. The treatment of poisoning 
from this article is to administer an emetic, or if vomiting i« 



Poisons and their Antidotes. 417 

preseni, as large a quantity of the whites of eggs, well mixed 
with water, as the stomach can contain. By the experiments 
of Orfila, it is proved that albnmen decomposes corrosive 
sublimate, forming a triple compound, consisting of albumen, 
muriatic acid, and calomel. Dr. Taddei, of Italy, has recom- 
mended wheat flour, starch or gluten, mixed with water, as 
an antidote to corrosive sublimate ; hence, when the whites of 
eggs are not at hand, either of the latter should be employed 
as directed above. 

The plentiful use of mucilaginous drinks is also very proper 
as an accessary remedy. The antidotes to corrosive sublimate 
are, therefore, albumen (white of eggs) and vegetable gluten 
(flour, starch, &c.) 

Tartar Emetic. — This substance, in large doses, is undoubt- 
edly a poision. It is by no means, however, so destructive as 
either of the foregoing. The remedies are, if vomiting be 
present, to wash the article from the stomach by large draughts 
of tepid drinks ; if vomiting be not present, to excite it by 
tickling the throat, and by the administration of large quan- 
tities of warm water, sweetened. If, notwithstanding these 
means, vomiting be not induced, we are to resort to antidotes. 
These are decoctions or infusions (teas) of any astringent 
vegetable substances. The following may be employed : a 
tea of Peruvian bark ; strong green or black tea ; a decoction 
of galls, of oak bark, or of any of the other astringent roots of 
barks. The above articles are named in the order of their 
efficacy. From the experiments of Berthollet, the Peruvian 
bark would appear most certainly efficacious, and when it can 
be procured, should invariably be preferred. "When tho 
vomiting is excessive, opium may be administered. 

The Salts of Copper. — These, in certain doses, are all pois- 
onous. Verdigris, or the impure carbonate, is the one most 
commonly employed. The symptoms are the same as in the 
case of other corrosive poisons. We are to endeavor, when it 
has been taken, to get it out of the stomach by the same 
means as have already been mentioned. Sugar was once 
considered as the antidote for this poison. Subsequent exper- 
iments, however, have lessened the estimation in which it was 
at first held, and have pointed out albumen as the article most 
to be depended upon ; nenoe, the whites of eggs mixed with 
water are to be administered at first ; their operation being 
aided by the use t£ large quantities of sugar and water. 
Should inflammatory symptoms remain after the presumed 
evacuation of tho poison, apply mustard or leeches to tho 



418 Poisons and their Antidotes. 

stomach. For the removal of the spasmodic affections that 
are apt to remain, laudanum or opium will be required. 

Sulphate of Zinc. — When taken in an over-dose, vomiting 
should be excited by copious draughts of warm water, emol- 
lient drinks of slippery elm, flax-seed tea, &c. Milk is the 
proper antidote. Inflammation is to be prevented by the 
ordinary means, and irritation allayed by opium. 

Muriate of Tin. — The treatment is the same as in the for- 
mer article : milk is also its proper antidote. 

Nitrate of Silver. — When accidentally taken in an over- 
dose, a solution of common salt in water is to be administered ; 
at the same time, the patient should take pentifully of emol- 
lient and mucilaginous drinks. 

Nitrate of Bismuth. — The same general treatment as in the 
case of other corrosive poisons, with milk and mucilaginous 
drinks plentifully administered. 

The Salts of Lead, when taken in large quantities, produce 
poisonous effects, and when gradually introduced into the sys- 
tem, they produce a peculiar species of colic, which has been 
already treated of. When taken in an over-dose, the proper 
treatment is to endeavor as speedily as possible to empty the 
stomach by the ordinary means. The sulphate of soda, (Glau- 
ber's salts,) or of magnesia, (Epsom salts,) is the most effectual 
antidote for lead : it should be given in strong solution ; at the 
same time, mucilaginous drinks and purgatives are to be ad- 
ministered. 

Sulphuric Acid. — Taken in an undiluted state, or in largo 
quantities, it produces all the symptoms attendant upon vio- 
lent inflammation of the throat, gullet and stomach, or when 
concentrated, it may destroy at once the lining membrane of 
those parts. 

Large quantities of calcined magnesia in milk, syrup, mo- 
lasses, or as little water as possible, must be instantly admin- 
istered ; or if not at hand, soap and water, chalk and water, 
or lime-water. The caustic must be neutralized, or the patient 
is inevitably lost. The subsequent treatment will depend 
upon the degree of inflammation present Demulcent drinks 
barley-water, gum-water, whey, milk diet and injections of 
thin gauel, will always be proper. 

Nitric Acid. — When taken in excess ; the treatment is to 
give fieely carbonate of soda, or magnesia, or calcined mag- 
nesia, or lime-water, and the other general treatment recom- 
mended above. 

The Alkalies, such as potash, ammonia, caustic soda, sal© 



Poisom and their Antidotes. 419 

ratus, &c. For these, when taken in excess, vinegar and 
femon-juice are the most valuable remedies : they are to be 
aided by the plentiful use of mucilaginous drinks and emol- 
lient injections. The remaining treatment will depend upon 
the degree of inflammation. 

Barytes — All the salts of this earth, except the sulphate, 
are poisonous in certain doses. When taken, vomiting is to 
be excited, and the plentiful use of a solution of sulphate of 
6oda, (Glauber salts,) or magnesia, (Epsom salts,) commenced 
with early. These decompose the poison and produce the in- 
soluble sulphate, which of course is inert. 

Nitrate of Potash, (salt petre,) when taken in excess, is a 
poison producing inflammation of the stomach, &c. Treat- 
ment, vomiting, mucilaginous drinks, and mustard to the 
stomach, according to circumstances. 

Muriate of Ammonia. — The treatment is the same at that 
directed in the last case. 

Acrid Vegetable Poisons. — The treatment for poisoning 
from these is, to dislodge the articles from the stomach as 
speedily as possible, by vomiting, and then to adminster large 
quantities of mucilaginous drinks, emollient injections, &c. 
To overcome violent irritation and spasm of the stomach and 
bowels, give frequent doses of opium and laudanum. 

Narcotic Poisons — Opium. — When opium or any of its 
preparations are taken in a large quantity, so as to act as a 
poison, the following symptoms are usually perceived within 
a short period ; insensibility and incapacity of exercising mus- 
cular motion ; breathing scarcely perceptible, and a small and 
feeble pulse, which usually becomes full and slow. As the 
effects of the poison increase, the state of stupor becomes more 
complete ; swallowing is suspended ; the breathing is occa- 
sionally laborious ; the pupils are insensible to the application 
of light ; the countenenance is livid or pale and death-like, and 
the muscles of the limbs and trunk are in a state of relaxation; 
vomiting sometimes supervenes; death is often preceded by 
convulsions. In cases of recovery, a weakness will sometimes 
be left in the lower extremities, nearly approaching to 
paralysis, and the bladder will be unable to retain its con- 
tents. 

The following are the directions for treating a case of poi- 
soning from opium : 

Induce vomiting, if possible, with sulphate of zinc, sulphate 
of copper, (blue vitrol,) or taitar emetic. In endeavor- 
ing to induce vomiting, great quantities of watery fluids will 
be improper, as they dissolve the opium and promote its ab- 



4:20 Poisons and their Antidotes, 

sorption. The vomiting should, therefore, be accomplished 
without the administration of any more liquid than is neces- 
sary to dissolve the emetie. 

The operation of the emetic may be accelerated by tickling 
the throat with the finger, a feather, &c, but as one of the ef- 
fects of this poison upon the stomach is to render the latter 
insensible to the impression of emetics, much time should not 
be lost in vainly waiting until they shall operate, when by the 
aid of the gum elastic tube and syringe, the contents of the 
stomach may be pumped out and fluids afterwards injected, so 
as entirely to wash out every portion of the poison. The pa- 
tient should n$t be allowed to remain quiet in one position, 
but should be moved about between two assistants ; stinging 
with nettles, or even the application of a cowskin has been 
proposed, and put in practice, under these circumstances, 
with good effect. 

Mustard plasters on the extremities should never be neglect- 
ed. The effusion of cold water is also a remedy of consider- 
able efficacy in rousing the system from the state of stupor in 
which it is thrown by the effects of narcotic poisons, partic- 
ularly the one under consideration ; large pitchers or buckets 
of water sheuld be splashed from a height over the head and 
shoulders of the patient, or over his whole body, and per- 
severed in until the patient indicates a return to a state of 
animation. 

Now administer alternately, water acidulated with any 
vegetable acid, and a strong warm infusion of coffee. The 
experiments of Orfila have shown that the exhibition of vege- 
table acids previously to the evacuation of the opium, is highly 
improper, as they accelerate and aggravate the action of the 
poison ; after, however, the latter has been entirely discharged 
from the stomach, water acidulated with vinegar, lemon-juice, 
©r other vegetable acid, tends to diminish and correct its ef- 
fects upon the system, to which, also, the infusion or decoction 
©f coffee is admirably adapted. 

In about ten or twelve hours, administer an injection, and 
let the arms and legs of the patient be well rubbed wrTh the 
flesh-brush, soft coarse flannel, or some stimulating appli- 
cation. Dr. Beck states that he has known the most happy 
results at this particular juncture, and during the latter stage, 
from repeated injections of a strong watery solution of assa- 
fcetida. So long as any of the opium is suspected to be 
retained in the bowels, purgative injections should be con- 
tinued. 

The above treatment for poisoning from opium or its pre- 



Poisons and their Antidotes. 421 

parations, and acid vegetable poisons, is adapted in all essential 
particulars, for poisoning from the various kinds of poisonous 
plants, herbs, &c. 

Iodine and Iodide of Potash — Give freely of starch or 
wheaten flour and water, combined with ipecac and warm 
water. 

Creosote, is coagulated and rendered comparatively harn> 
less, by white of eggs, or if not to be had, starch or flour and 
water, given freely, with ipecac and warm water, sweetened. 

Green Vitriol, or Copperas. — Give freely of carbonate of soda 
and water, followed by ipecac and sweatened water, and then 
give cold coffee, to strengthen the system and quiet the nervous 
pain. 

Poisonous Pish. — Give an emetic of ipecac, and warm 
sweetened water, or tickle the throat to produce vomiting. 
Then give a purge of castor oil or Eochelle salts or Epsom salts, 
and if necessary, injections of soapsuds up the bowels. 
Afterwards give a drink of vinegar, sugar and water, frequently. 
A dose of laudanum may also be needed to produce sleep. 

ERYSIPELAS. 

This disease is also called "St. Anthony's Pire" or*" The 
PoseP and is an inflammatory affection of the skin alone, or of 
the skin and cellular tissue or soft substance beneath the skin. 
Like other inflammations, it varies in degree and extent, in 
different cases. When it effects merely the external surface of 
the skin, in which case the letter is red, not sensibly swollen, 
soft and without fluctuation, the disease is termed erythema. 
The cases to which the term erysipelas is more generally ap- 
plied, are marked by the same symptoms as above, but of a 
more intense grade ; there is greater redness, considerable 
swelling, a peculiar burning pain, and an effusion takes place 
beneath the skin, raising the latter in the form of blisters of 
various sizes ; very generally there is effusion also in the sub- 
cutaneous cellular tissue. The most aggravated form of the 
disease is termed phlegmonous erysipelas ; in this both the skin 
and cellulars membranes are inflamed, and extensive collections 
of matter and sloughing of the cellular structure are quickly 
produced. 

Erysipelas usually affects the face and limbs ; less frequent- 
ly, especially in adults, the surface of the chest and abdomen. 
In a few instances, the disease has been known to pervade the 
entire surface of the body. 

The disease is confined to no particular sex or constitution. 
It is more common, however, in infants and young children, as 



422 Erysipelas. 

well as in the aged, than in persons about the middle period 
of E£e. It likewise more frequently attacks females than 
Miales ; and persons of a sanguine and irritable temperament, 
and of luxurious and intemperate lives, are more liable to its 
attacks than any others. 

Erysipelas is confined to very small spaces sometimes, in 
others it extends over the whole head and face, or occupies 
an entire limb. It not frequently commences at a point 
and gradually extends in every direction, until it involves a 
very large portion of the skin. In other instances, in the part 
first attacked, the inflammation runs through its various 
stages and disappears, while it subsequently extends over a 
new surface to pursue the same course. In this manner, it 
may travel gradually from the head to the feet. In other 
cases, again, the erysipelas may suddenly disappear from the 
part primarily affected, to reappear in another and remote 
part of the body. It occasionally happens, that when the dis- 
ease very suddenly disappears from the skin, some internal 
organ, and particularly the brain, in cases of erysipelas of the 
face, suddenly present all the symptoms of inflammation. 

The part affected with erysipelas in its simplest form, pre- 
sents the ordinary symptoms of inflammation, namely, swelling, 
heat, and redness. The swelling, however, is softer, more 
irregular and diffused than in common inflammation; the 
heat is more intense, and the accompanying pain is a burning 
or smarting, similar to that from the application of mustard 
or scalding water, in place of being throbbing as in the 
latter ; the redness is brighter and more intense and disappears 
upon pressure, but returns the moment the pressure is re- 
moved. When erysipelas attacks a limb, in general the whole 
circumference of the latter becomes enlarged, and the skin 
presents a kind of smooth shining appearance, and a some- 
what doughy feel, as though a fluid was effused beneath it, 
which is, in fact, the case in most instances, when the disease 
is of any violence or extent. When the face is the seat of 
erysipelas, the features become deformed ; the mouth is often 
drawn towards one side , the nose is enormously enlarged, and 
the eye-balls, becoming swollen, close up the eyes entirely. 

In a few days, the period differing in different cases, vesi- 
cations, (blisters,) varying in size, arise upon different parts of 
the inflamed surface especially towards its centre. They are 
of an irregular form, and filled with a fluid, at first clear and 
watery, becoming subsequently straw-colored. The skin after 
a time, gives way, allowing the fluid of the blisters to escape, 
which generally drying upon the skin, covers it with thin 



Erysipelas. 423 

scales. About the eighth or ninth day of the disease, but 
occasionally much later, the redness of the affected surfaces 
changes to a brownish or yellow hue ; the vesicles entirely 
subside, and the 6kin dries and scales off. 

In general, the disease is preceded and accompanied with 
fever, varying in its character according to the constitution, 
age, and general state of health of the patient. In the young, 
the robust, and those of full habits, we have a very decided 
attack of fever, and often of considerable intensity. When 
the face or scalp is the seat of erysipelas, there are often pain 
and oppression of the head, inclination to sleep, or delirium. 
The tongue becomes dry and brown ; the pulse rapid and 
feeble, with great loss of muscular strength. In other cases, 
the heart and nervous system are less affected, but wo have 
pain in the stomach, foul tongue, a bad taste in the mouth, 
nausea and costiveness of the bowels. 

This disease is produced by the same causes as other inflam- 
mations. It may result from cold and various irritants applied 
to the skin, or it may be produced sympathetically from irri- 
tations seated in the stomach and bowels. Phlegmonous ery- 
sipelas very generally results from wounds, bruises, extensive 
ulcerations, or from the influence of cold. 

The treatment of this disease, when it is possible, should be 
entrusted to a good physician, but in many cases this is not 
the case. The following plan of domestic treatment is recom- 
mended : Always begin by giving an emetic, (vomit,) of ipecac; 
then clear out the bowels by the following mixture : mix ten 
grains of calomel, ten of Dover's powders, ten of rhubarb ; di- 
vide into three parts, give one part every two hours ; to be 
followed by a seidlitz powder, if the bowels are not freely 
opened in ten hours. If this mixture is not to be had con- 
veniently, a dose or two of castor oil or Rochelle salts, or 
other good purgative will answer, giving at the same time 
nauseating doses of ipecac, (about half to one grain of the 
powder every two hours.) In weak or delicate person** these 
nauseating doses can be dispensed with, after one vomit in the 
beginning. 

The local treatment is also of much importance ; the best 
application to the inflamed part is caustic, nitrate of silver. 

Erysipelas tending to spread, may be stopped by surround- 
ing the affected part entirely with a cauterized ring. The 
parts to be touched must, in the fist place, be shaved, if cov- 
ered with hair, and the skin must always be thoroughly 
cleansed from its natural oily secretion, by washing with soap 
and water. It must then be moistened all round, and the 



424 Erysipelas. 

etick of caustic drawn slowly and gently over it, so as to make 
a line of demarcation at least a quarter of an inch broad ; but 
this line must be entire throughout-— deficiency in one spot 
may permit tke inflammation to extend by the outlet. It is 
not asserted that in every case this caustic line will inevitable 
stop the disease, but it will do so in the majority, if care be 
^taken that it is efficiently done, and that it includes, without 
'doubt, every portion of the affected skin. "When the solution 
of caustic is to be used to quell the disease, it should be used 
of the strength of forty grains to two drachms of water. The 
inflamed surface must be gently cleansed by soap and warm 
water, and the solution applied all over it by meams of a 
camel-hair brush or a feather. The practice now recommend 
ed is perfectly safe, is very efficacious, both as a preventive 
against the extension, and as a cure of this formidable disease, 
and might be quite justifiably employed by an intelligent per- 
son in the absence of medical assistance. 

Flour is a very common and often a good and comfortable 
local remedy in mild cases of erysipelas; hot fomentations, 
either of simple water or a decoction of poppy-heads or hops, 
applied continuously for many hours, by means of flannel, 
give much relief in some cases; or a lotion composed of twenty 
grains of sugur of lead, a drachm of laudanum, and sixteen 
ounces of water, may be used slightly warm, and applied by 
means of linen cloths, with much advantage. A poultice 
of charcoal, slippery elm, and hops, frequently renewed, is 
also a good remedy in mild cases. 

Erysipelas is the most formidable enemy which can gain a 
footing in a surgical hospital ; and for the same reason, when 
the disease occurs in private houses, caution should be ob- 
served that persons suffering from wounds do not come into 
close contact with the affected ; and, indeed in any case, the 
same precaution should be adopted in erysipelas as in conta- 
gious diseases generally. This is doubly requisite in a house 
m which a confinement is expected, or has recently taken 
place, for there is an undoubted close connection between 
erysipelas and fatal childbed inflammation, and under sueb 
circumstances too much care can not be exercised. White lead 
paint, ground in oil, applied to the parts afflicted, is a valuable 
remedy. 



Telling Diseases by the Tongue. 425 

Telling Diseases by the Tongue. — Much 

could be 6aid about this " unruly little member," but in tho 
present case we are only taking it into consideration in a 
medical point of view, in what is to be regarded both with 
reference to its own disorders, and to the indications it affords 
of disorder in other parts of the system. 

The condition and appearance of the tongue, are indications 
almost always consulted by a physician in investigating a case 
of disease, and most valuable guides they are at times, when 
experience, observation, etc., have given the power of reading 
them aright. When the appearances of the tongue, however, 
are admitted as evidence, consideration must always be given 
to the natural state of the organ in the individual, for some 
never have a clean tongue, while in others it scarcely becomes 
furred, even when considerable disorder is going on in the 
system. In chronic disorders, especially of the digestive 
organs, the most valuable indications are often afforded by the 
tongue, immediately after the nights sleep, before food has 
been taken. Persons who sleep with their moutns open, gener- 
ally have a dry tongue in consequence, but m most persons in 
health, the mouth should be pleasantly moist on awakening 
in the morning; if it is the reverse — if the tongue is dry, er 
clammy, or viscid, and covered with fur, there is usually dis- 
order of the digestive organs, permanent or temporary, from 
some indiscretion in food, and especially in the use of stimu- 
lants. In feverish conditions of the system generally, the 
tongue is liable to become dry. The appearance of the fur 
on the tongue varies greatly ; it may be thick and dirty-white, 
as it is in stomach and febrile disorders, and esneciallv in sore- 
throat ; it may be a thin, creamly-looking white, as in inflam- 
matory disease with the abdomen ; or it may be yellow, as 
in biliary disorder. It may be patchy, as in scarlet fever ; or, 
the centre and sides of the tongue being preternaturally red, 
as in some forms of intestinal (bowel) irritation, may contrast 
with the white fur in other parts. Further, the tongue may 
be morbidly clean and red also in intestinal irritation, and ia 
hemorrhage ; in the former case, perhaps, feeling sore, as & 
scalded. Again, partaking of the general debilitated condi- 
tion of the system, the tocgue may be pale, when it is alse 
usually broad and flat, indicating general want of tone anil 
power in the muscular fibres. The motions of the tongue, 
moreover, when it is protruded, give a clue to the state or the 
nervous system especially ; thus in parly sis, it is drawn fee 
one side ; in delirium tremens and nervous affections, it is 
tremulous ; in the low stages of fever, it cannot be protruded 



426 Symptoms of Diseases. 

at all. Persons, therefore, who hear physicians ask a patient 
to put out the tongue, should bear in mind that it means some- 
thing more than " putting on professional airs." 

Symptoms of Diseases. — As it is of the very greatest 
importance to ascertain at the beginning the nature of every 
disease, we give here a few of the leading symptoms of dis- 
eases, as they ordinarily make their appearance. I In observ- 
ing and forming deductions from symptoms, the first questions 
ought to be — do they indicate an acute attack ? have they 
supervened suddenly ? and if 60, to what can the attack ba 
traced ? Has there been exposure to cold and wet, or to 
checked perspiration ? — those fruitful sources of inflammatory 
and rheumatic affections. Has there been exposure to contag- 
ion in any form, or to malaria of any kind, or is there any 
prevailing epidemic ? Can any violence, at no very distant 
date, account for the attack ? Careful consideration of the 
" history " of the affection will often throw much light upon 
its nature. Again, if the usual symptoms of fever indicate 
inflammatory affection, it is to be considered whether pain or 
uneasiness in any part, or disordered function of any organ, 
indicate that the disease has localized itself. If inflammatory 
symptoms are absent, the spasmodic character of pain, or the 
nervous character of the disorder, become questions for con- 
sideration. Should the symptoms of ailment be chronic, the 
same consideration of the history and of the hereditary ten- 
dencies ought to be entered into, and attention particularly 
directed to the fact of there having been progressive loss of 
flesh, habitual complaint of cold, unusual lassitude, alteration 
in the complexion, difference in sleeping, etc. 

By systematizing inquiries and observations, a much clearer 
idea will be gained of the state of an individual who is an 
object of care and solicitude, than by making them at ran- 
dom. Thus beginning at the Head, attention should be direct- 
ed to any unusual sensations complained of by the person, or 
any unusual manifestations apparent to other. These ares 
pain, giddiness, affection of the senses, confusion of thought, 
t>r impairment of mental power ; flushings, twitchings, draw- 
ing of the features to one side ; disturbed sleep ; moaning, 
f rating of the teeth; sleeplessness, or too great sleepiness, 
'assing downward to the Organs of Respiration (breathing) 
alterations in the character of the voice ; in the respiration, 
as to the frequency or otherwise ; in the power of lying in 
any or every posture, are all matters for observation ; also 
any habitual cough, and its character. When the Digestive 



Salivation. 427 

Organs are disordered, the period of their chief disorder, as 
connected with taking food, is an important symptom ; 
whether the uneasiness comes on quickly after a meal, or not 
for some hours ; whether it is worse after long fasting, or the 
reverse ; whether there is habitual vomiting, etc. With 
respect to the Bowels, the nature of the motions or stools is to 
be inquired into, and especially the fact of thorough daily 
relief. In inquiry into the state of the urinary organs, the 
amount of the secretion, its nature as to color, or its ten- 
dency to deposit sediments immediately after being passed, or 
when it become cool, are principal objects. If the calls are 
too frequent, it is to be noticed whether this depends on in- 
creased quantity or on diminution, which causes irritation 
from greater concentration. In this way, by carefully and 
systematically considering a case, even an unprofessional per- 
son may acquire very considerable knowledge of its leading 
features, sufficient probably to enable him to refer to those 
articles in this work from which he will derive proper infor- 
mation ; in many cases, sufficient to open the eyes to a condi- 
tion of health that calls for the prompt submission to proper 
medical advice. When this is determined on, the observation 
of symptoms, either in his own case or that of another," such 
as a child, will enable any individual to furnish a physician, 
even at a first interview, with such a history as will afford him 
much assistance in forming his opinion. That makes a work 
of this kind of great value to every family, in fact to every 
indivdual. 

SaliVdtlOn. — It is to be hoped that the day for " dosing 
with mercury" for the many ills that flesh is heir to, has 
past. The first symptoms of the constitution being affected 
by mercury, or of approaching salivation, is a sense of ful- 
ness and tenderness of the gums ; the teeth feel as it were 
elongated, and the person cannot bite any firm substance, 
such as crust, as well as usual ; coincident with these symp- 
toms, the breath acquires a peculiar fetor (bad odor), which, 
once 6melled, cannot be forgotten, and the gums, if examined, 
are seen to be slightly swollen, and of rather a purple hue. 
Sometimes the face swells to an enormous size, and presents 
hideous appearance. There are some constitutions so suscep- 
tible of the action of the medicine, that the smallest dose 
cannot be taken without its producing free, or even violent 
salivation. Unfortunately, but little can be done to cut short, 
or even alleviate greatly, a course of mercurial salivation, 
cold, of course, is to be avoided, the alum wash for the 



428 Influenza* 

month, or tincture of myrrh, or camphorated spirit in water 
used to rinse the mouth, afford some relief. A lotion made 
with two teaspoonfulls of ether, or spirits nitre, to eight ounces 
of water, is also serviceable, and diminishes the fetor ; a so- 
lution of common salt, in the same proportions, will have 
the same effect. A few leeches may be applied under the 
jaw. Seidlitz powders, or Epsom salts, largely diluted, may 
also be given with advantage, if the patient can swallow 
them, and is not in a very reduced state. A tablespoonful of 
a mixture of equal proportions of flowers of sulphur and 
cream of tartar, given once a day, on a fasting stomach, is 
often beneficial. Also a wash of white-oak bark, (tea,) cold, 
used freely every two hours, is beneficial. Cold green tea. 
also, and strong coffee, cold, are good remedies. 

InflUGnzd* — This disease consists of peculiar feverish 

attack, accompanied with catarrhal affections of the air-tubes 
of the lungs, and great prostration of strength. It is not un- 
common to call various forms of cold and catarrh, influenza ; 
but the true influenza is a very distinct disease, and sel- 
dom occurs but as an epidemic, attacking large numbers at 
once.- The symptoms of influenza are those of general fever ; 
coming on suddenly, there is shivering, loss of appetite, per- 
haps vomiting, heat, and thirst, with cough, headache, and 
generally great depression and languor. The feverish symp- 
toms may last from one day to ten, but their general duration 
is from three to five, or even seven days, the cough usually 
remaining a variable time after the acute symptoms are gone, 
according to exposure and circumstances, such as a predispo- 
sition to cough, etc. 

To the strong and healthy, influenza is but a trifling dis- 
ease. It certainly prostrates even them for a few days, and 
leaves them weals ; but it is in almost all cases perfectly de* 
void of danger — with ordinary care — and requires little or 
no medicine. A few days in bed, according to the severity 
of the case, with low diet, a gentle purgative and diluent, 
drinks such as flaxseed tea, lemonade, with gingers, tea, etc., 
and the feet in hot water, being all that is required. If 
the catarrhal symptoms are severe, treatment similar to 
what is recommended for catarrh or cold may be had re- 
course to. 

To the weakly and the aged, influenza is, on the other hand, 
a comparatively fatal disease ; and, from the almost univer- 
sal nature of its attack, carries off more, perhaps, of these 
classes than many more apparently severe and more dreaded 



Change of Climate, or Acclimation. 429 

disorders. The attack of influenza, in the description of per- 
sons above mentioned, should be the signal for medical at- 
tendance. "Weakening medicines, especially, must not bo 
resorted to ; eanfinement to bed and the use of warm teas, 
will be required ; broth, strong or weak, must be allowed, ac- 
cording to circumstances ; if the strength is deficient, wine 
may be requisite, and stimulant expectorant medicines, espe- 
cially in the aged, if the expectoration is abundant, viscid, 
and difficult to be got up. In such cases the following will 
be found useful : — Take of carbonate of ammonia, thirty to 
forty grains ; tincture of squill, one drachm ; wine of ipecac, 
forty drops; water or camphor julep, sufficient to make an 
eight ounce mixture, of which, two tablespoonfuls, or one- 
eigth, may be given every few hours. If the cough is very 
irritating and troublesome, two drachms of paregoric may be 
added to the above, but the opium rather tends to check the 
free expectoration which is so desirable. Demulcent drinks, 
6uch as barley-water, etc., should not be neglected, and a mus- 
tard plaster or blister to the chest will do good. In severe 
forms of the disease, with difficult breathing, if the strength 
is much reduced and the appetite bad, two doses -of decoction 
of Peruvian bark may be given during the-day. 

Persons who greatly suffer from delicate chests, should be- 
ware of allowing the effects of influenza to hang about them ; 
as the debility and cough are very apt, if predisposition exists, 
to lay the foundation of consumption. The strong and 
healthy may trust to the domestic management of influenza ; 
but the weak and aged ought to have proper medical advice, 
if it is within reach. Many persons of frail constitution, who 
might have lived for years with proper care, have fallen vic- 
tims to effects of influenza, colds, etc. 

Change of Climate, or Acclimation.— it is a fact 

worthy ot remark, that the air and its temperature are largely 
concerned in the process of acclimation ; the former is 80 
much more rarifled in hot than in cold climates, that in the 
vital process of respiration, a comparatively much smaller 
quantity is habitually consumed; less oxygen if taken in, and 
the process of oxidation or combustion, which is continually 
going on within the body, is slower ; we reasonably conclude 
that by this process of combustion, the animal heat, in part 
at least, is maintained; but of course, in a hot climate, a less 
active condition is sufficient to keep up the average tempera- 
ture.. The process of oxidation or combustion effected on the 
qhq hand by the oxygeu inspired, is supported ou the other 



430 Change of Climate, or A xlimation, 

by some of the elements — carbon and hydrogen— of the food. 
It is evident, therefore, that if an individual who has become 
resident in a hot climate, makes a practice of consuming as 
much nutriment as he used to do, without injury to health, 
in a cold one, he must take more than is requisite ; conse- 
quently the blood becomes overcharged with a quantity of 
noxious matter, which the rarified air and inactive habits of 
warm countries do not tend to remove ; and if the course be 
continued, an attack of illness, probably of a biliary nature, 
is the consequence. Even in temperate? climates, the differ- 
ence between the consumption of oxygen, in winter and in 
summer, is considerable. How great must be the difference 
to |:hose who permanently settle in tropical heats \ certainly 
sufficient to require much alteration in habits of living. The 
abundant animal diet, the fats and alcoholic drinks of the 
cooler climes, all of which contain carbon and hydrogen in 
abundance, and assist materially in sustaining temperature 
must give place to the fruits, vegetables, etc., of warmer re- 
gions ; vice versa, on going from a warm or temperate coun- 
try to a colder — as the experience of all arctic travelers testi- 
fies—a larger portion of animal diet, and that of a more 
fat or oily character, is requisite to maintain health and 
strength, and those only who are capable of consuming and 
digesting this full allowance, are fit for encountering the cold 
of the north. From what has been said, it is evident how 
important due regulation of the food is to safe and speedv 
acclimation ; it is the main element, and the most under man's 
control. Modern science and discovery will render him much 
assistance, but study of the natural products of the soil and of 
native habits is essential. 

The great increase of the functions of the skin which takes 
place on removal to a warm climate, requires attention* It 
renders the constitution more susceptible to the influences of 
a damp or chill air, such as frequently occurs in evening. 
The best preservative is woollen clothing of some kind, be "it 
ever bo thin, worn next the skin. Persons who>, from a warm 
climate 1 , of which they are either natives, or to which they 
have become accustomed, come to reside in a variable or cold 
country, are peculiarly liable to affections* of the chest or 
lungs, and not unfrequently become the subjects of consump- 
tion, for the want of a little timely medical advice, which a 
work like this, is intended to give.. Such persons should by 
all means go more warmly clad than those who have been 
raised or acclimated to a northern country — putting on an 
extra flannel under-shirt by all means* 



Chilblain — Nervousness, or Nervous Diseases. 431 

Chilblain, — This disease, though not very frequent, is 
quite troublesome ; it is an inflamatory affection of the 
skin, more particularly of the fingers or toes, caused by alter- 
nations of cold and heat, and is characterized rather by irri- 
tating and troublesome itching than by pain. Persons of fine 
skin, scrofulous constitution, or languid circulation, are most 
liable to suffer from chilblains, and old people and children 
more than those of middle life. The sudden exposure of the 
6kin when very cold to a high state of temperature is gener- 
ally and justly considered to be an exciting cause of the af- 
fection ; but one quite as frequent is keeping the surface in a 
state of artificial warmth, by the use of sleeping-socks and 
hot applications in bed, or of fur-lined shoes and foot-warmers 
in the day time. All these applications keep the skin in a 
continual state of unnatural perspiration, weakens its tone, 
and so render it more susceptible of the effects of cold when 
exposed to it. To prevent chilblains, in the predisposed, the 
feet ought to be regularly bathed with cold, or (in the case of 
the aged) tepid water, or saltwater, every morning, and after- 
ward well rubbed with a rough towel, exercise being employ- 
ed to preserve the warmth of the extremities rather than 
artificial heat. When chilblains have formed, and the skin 
is unbroken, stimulating applications are requisite; many 
different ones are used — spirit, such as brandy, camphorated 
spirit, paregoric, or turpentine, will any of them be of service 
applied by means of a piece of linen, or gently rubbed on. 
When the skin of a chilblain breaks, an ulcer is the conse- 
quence, which discharges a thin slimy fluid, and is often diffi- 
cult to heal. In this case, the inflammation should be subdu- 
ed, in the first place by means of a poultice, and afterward 
an ointment used, made with ten grains of sugar of lead, to 
the ounce of lard. Of course all friction or pressure from 
boots or shoes must be guarded against. Frequently anoint- 
ing the parts with sweet oil or lard may be beneficial. 

Nervousness, or Nervous Diseases. — The term 
"Nervousness" is a kind of undefined expression, after a 
manner of speaking ; and yet, call it what we may, the disease 
is very prevalent. Females ar3 much more liable to nervous 
disorder than males, independent of hysterical affection, 
■^vliich constitutes one of the most most marked phases of the 
llna'ady, and many of the remarks on which apply to the pre- 
sent subject. 

In nervous disorders, there is usually great susceptibility to 
external influences, and at the same time mental emotions, 



432 Nervousness, or Nervous Diseases, 

whether of joy or grief, fancied or real, exert much influence 
over the body and its functions. The heart palpitates, the 
hand trembles, the face flushes under the most trivial excite- 
ment. Much of this is undoubtedly due to constitutional 
timidity ; but it is also notably increased in debilitated states 
of the constitution, and those who have never been what is 
called "nervous," are apt to become so in some particular 
condition of impaired health. The affection is, indeed, very 
nearly akin to hypochondriasis (lowness of spirits) ; it is essen- 
tially a disorder of weakness, and is relieved by whatever in- 
creases, temporarily or permanently, the power of the ner- 
vous system. The temporary relief to nervous sensations 
which is afforded by alchoholic stimuli, is very apt to lead 
those who suffer from them to put too much trust in, and to 
resort too habitually to the use of these palliatives — a prac- 
tice which must be followed by pernicious consequences ; 
sometimes, too, opiates are habitually-made use of, and are no 
less injurious. 

Undoubtedly, when properly, employed, alchoholic stimnli, 
and even opium, are valuable in the treatment of nervous dis- 
ease, but they must never be substituted for more permanent 
means of invigoration, particularly regular and sufficient ex- 
ercise in the open air, on foot or horseback, good nourishing 
diet, with a sufficient amount of animal food, and attention 
to the bowels and the state of the skin. The producing cause, 
whether excessive mental exertion, sedentary employment, 
late hours, or excess of any kind, must of course be modified 
as much as possible. The shower bath is often recommended, 
and often useful in these affections, but some persons cannot 
bear the shock ; when this is the case, the cold or tepid bath 
down the back does much good, particularly if there be any 
tenderness of the spine on pressure, a fact which should al- 
ways be investigated in those who suffer much from nervous 
disease ; it very commonly exists and is overlooked. When 
the tenderness is at all marked, it will require special treat- 
ment by counter irritation, by the use of liniments, friction, 
etc. In addition to the regulation of the bowels, by proper 
purgatives, or by injections, quinine (one grain three times a 
day), and the preparations of iron, are the most generally 
useful remedies ; tincture of valerian may b«», used as a pal- 
liative during an aggravated attack, but shonld be sparingly 
resorted to ; or tincture of valerian and hyoseyamus used to- 
gether in equal parts (one teaspoonful three times a day) may 
be tried. 



Fullness of Blood* or Plethora. 433 

Fullness of Blood, or Plethora.— It is not unusual 
•o see what are called robust, strong, full-blooded persons, 
that look to be the picture of health, and yet they are any- 
thing but well ; being always exposed to danger from the too 
great fullness of the blood vessels, and richness of blood. 
Individuals of the sanguine temperament, while leading a life 
of mental activity and anxiety, have greater powers of activ- 
ity than most others, but they, in many instances, border 
upon plethora, and if they become so placed that their former 
activity is either uncalled for or interfered with, provided 
there is not much mental anxiety, they quickly become ple- 
thoric ; the vessels are overloaded w*th rich blood, and instead 
of the former power of exertion, oppressive languor and inac- 
tivity succeed ; in fact, the whole of the functions, and the 
nervous system especially, are weighed down and clogged — ■ 
there is mental sluggishness, heavy sleep, and inaptitude for 
exertion. This last symptom is too often mistaken for weak- 
ness; the person laboring under the mistake resorts to addi- 
tional food and stimulants — it need scarcely be added, only 
to increase the evil. An individual in this condition, it may 
be said, is ripe for inflammation ; if cold be taken, it is very 
likely to light up inflammatory action somewhere, and once 
lighted up, the action is very liable to be of the severest kind. 

Should febrile disease of any kind — as for instance, small- 
pox, or erysipelas, or rheumatic fever, be excited in the con- 
stitution, the symptoms run high, and the case is very likely 
to become one of danger. For similar reasons, accidents aro 
not well borne : at least their after effects are often such as to 
put life in danger. 

Persons who are in a plethoric condition, not unfrequently 
get relieved by some natural effort ; piles show themselves 
and bleed, or the nose bleeds, or spontaneous diarrhoea comes 
on, and instead of the individual being weakened, he feels 
stronger than before. The evil results of mistaking a state 
of oppression from plethora, of false debility for one of weak- 
ness, must be evident to all. Even the pulse is liable to de- 
ceive, and in these states of oppression to seem low and weak, 
but it is essentially different from the pulse of debility. The 
latter, if the finger is pressed even slightly upon it, is extin 
guished at once ; but the pulse of oppression seems rather to 
resist the pressure, to become stronger, and to beat up against 
the finger, rather than to give way. As might be expected, 
plethoric individuals are often the subjects of apoplexy. A 
state of plethora must always be one, if not of danger, at 
least of hazard, and ought to be guarded against. 



434 Old Age. 

If a person suffering from plethora is threatened with an 
On mediate attack, such as apoplexy, the condition camnot be 
$©o soon or too actively removed. Bleeding in some way, 
free purging, and low diet, are the immediate remedies; but 
in the absence of any threatened attack, it is not advisable to 
invoke the aid of these powerful agents ; the system should be 
reduced gradually and steadily by the formation of, smd per- 
severance in, modes of living suited to counteract the ten- 
dency. When a man suffering from the effect of plethora 
gets rid of his unpleasant symptoms by a " coup," such afl 
the loss of a basinful of blood, by a few calomel xMs aod 
black draughts, he is probably highly pleased to be so easily 
rid of his enemy, and by means which involve i^o self-restraint 
or giving up of indulgences ; so, trusting to th« repefci&cwi of 
the same remedial measures, he puts no check upon bi-msetf, 
and when the plethora again reaches a certain height, he 
again bleeds and purges, and this goes on until he is overtake* 
some day with an apoplectic attack, or until he becomes {he 
subject of organic disease. 

Persons who have a tendency to plethora, must have exer- 
cise — they must use up their blood and muscle in active mo- 
tion ; but in doing this, especially at first, they must beware 
of over-doing it. It will not do for a plethoric man to com- 
mence a new system of living for health, with violent exer- 
tion — otherwise he might precipitate the very evil he dreads. 
Plethora, to be reduced, must be so steadily but gradually ; 
active exercise, increased as the ability to take it increases, 
must be balanced with food proportioned to the amount taken, 
and animal food in every moderate proportion used. Early 
hours, and curtailment of the time devoted to sleep, is desira- 
ble. In most cases, tepid bathing is preferable to either hot 
or cold, and, either by it or by sponging, the skin must be 
kept active. The bowels require especial attention, and are 
better rather lax than otherwise ; and slight tendency to ple- 
thoric oppression being counteracted by acting upon them by 
J proper purgatives, such as Epsom salts, or byseidlitz powders, 
if the kidneys are inactive, spirits nitre, twenty to forty drops 
three times a day, in a wineglass of water, or a teaspoonful 
of cream tartar in some quantity of water, about three or 
four times a day, will be beneficial. 

Old Age* — " The youngest of us will be old some day, if, 
we live long enough," sounds a little on the Hibernian order, j 
but the idea intended to be conveyed is not a bad one, and we 
should not forget the aged and the infirm. With old age 



Old Age. 435 

increases the liability to such hereditary diseases as gout, gravel, 
rheumatism, apoplexy and paralysis, and in women especial- 
ly, to cancer. Now the effect of excesses and dissipation in 
early life, which may have been unfelt during the vigor of 
manhood, too often "add to the natural infirmities. Whatever 
may have been the previous modes of living, it is always a 
dangerous experiment to make material or sudden change in 
them-; after age has begun to tell upon the constitution, it 
should not be done, but for important reasons, and under 
medical advice. The weakened digestion of advanced life 
should be considered in the food, which, while it is nutritious, 
ought at the same time to be lightly cooked, and everything 
like hardening avoided. Where the teeth are deficient, meat 
should be well divided, either by mincing before cooking, or 
by the knife after. The meals should be light, not at too long 
intervals. If the dinner be early, as it ought to be for the 
aged, who are not obliged to hurry off to business, supper, 
though a light one, should always be taken. The skin of old 
people is often most shamefully and disgustingly neglected, 
and no point in their management is more closely connected 
with their comfort and health ; it should frequently be spong- 
ed with tepid water, and well rubbed afterward with a rough 
towel,, to promote reaction. It ought at the same time t'6 bo 
carefully protected by woollen clothing: old people are mos$ 
injuriously susceptible of the changes of external tempera- 
ture, particularly cold. Exercise by the old should be con- 
tinued as long as they are able to take it, but never extended 
to fatigue. Sleeplessness, so frequently and so loudly com- 
plained of by aged people, is, in some respects, natural ; as 
life advances, nature would seem to require less of the soft 
restorer. It i3 not well to endeavor to overcome it by nar- 
cotic medicines. If possible, the time of sleep should, by 
habit, be kept to the early hour3 of the night ; and, in sum- 
mer especially, the tedium of the early morning may bo 
relieved by reading, knitting, sewing, or some other light em- 
ployment. In advanced life, the urinary organs require the 
greatest care ; the call to relieve them should never on any 
account be delayed; on the slightest symptoms of derange- 
ment, proper medical advice ought to be taken at once \ it 
may prevent evils which too often render the latter years 
miserable. It is most important for old people to give them- 
selves time to empty the bladder thoroughly ; they do th;a 
with more difficulty than the young. The medicines pre- 
scribed for the aged should be, whenever it is possi 1 , e, of a 
warm character, to counteract the tendency to flatulent dig* 



436 Flatulence. 

tension ; large doses of mercurials, neutral salts, and strong 
purgatives, are all to be avoided. Pills, especially if <it all 
hard, are apt to pass through the bowels unchanged. When 
a mild purgative is required by an old person, none is more 
suitable then a moderate dose of infusion of senna, to wliich 
a little ginger, or a teaspoonful of Peruvian bark, ©r of gen- 
tian root, is added. Six or eight drachms of the compound 
decoction of aloes answers well, if there is no great tendency 
to piles. When the bowels ar& habitually constipated, injec- 
tion of a pint to a pint and a half of warm soap-water, must 
be given occasionally as required ; this counteracts the great 
tendency to accumulation in the bowels. The doses of medi- 
cine ought always to be diminished after the period of incipi- 
ent old age, as old persons do not bear the effects of medi- 
cines so well. 

F§8tu!©nC©. — This is commonly the result of indigestion, 
but it is often also the effect of nervous disorder. In the 
former case, it is probably chiefly due to the extrication of 
gas from the badly-digested food-mass in a state of partial fer- 
mentation. In the latter, it is only possible to account for 
the enormous quantities of u wind " which are discharged by 
its formation (secretion) in the bowels. Toward the termi- 
nation of fever and other acute diseases, flatulent distention 
of the bowels, or " tympanitis," as it is called, is always an 
unfavorable symptom. 

Persons who suffer from flatulence require sedulously to 
avoid most kinds of vegetable food and fruits. Individual ex- 
perience, however, is tbe best guide on this head. "When a 
severe attack of flatulence comes on, carminatives, such as 
chewing a piece of calamus or ginger root and swallowing 
the juice, a few drops of peppermint in water, or eating some 
peppermint drops, are generally resorted to, and often prove 
useful. A drink of water as warm as it can be taken, is often 
a very good and simple remedy. But in many cases, partic- 
ularly in nervous individuals, with pale tongues, the mineral 
acids will often be of more service — either twenty or thirty 
drops of dilute nitric acid in a wineglassful of infusion of 
orange peel, or some other warm bitter ; or, better still, aro- 
matic sulpheric acid, in ten drop doses, in a wineglassful of 
water. As preventatives, keeping the bowels well open, and 
the use of the flesh-brush over the stomach and bowels twice 
a day, and plenty of out-door exercise, are the best. Person^: 
subject to this complaint should be careful to eat slowly ancjp 
chew their food well. 



JVbises in the Ears — Weakness of the Bladder — Bile. 437 

NOiSQS In the Ears. — These are often compared to the 
sounds of " bells ringing," " simmering of water in a kettle," 
"singing of insects," "roaring of the sea," <fee. They aro 
often extremely troublesome, and may arise from many and 
different causes. Mere temporary derangement of the di- 
gestive organs will in some persons produce them. They are 
often indicative of determination of blood to the head, and 
when accompanied by symptoms of this tendency, ought not 
to be neglected. Partial obstruction of the Eustachian tube 
by cold, or accumulation of wax in the external ear-passage, 
are apt to occasion these noises, and they are accompanied 
with some degree of deafness. Of course the remedy must 
vary with the cause. If the digestive organs are deranged, 
they must be regulated ; if cold be the cause, the symptoms 
may be left to pass away with the temporary ailment. In 
some cases of chronic or continued noise in the ears, regu- 
larly bathing the head with cold water every morning will 
sometimes remove it, when other remedies fail. 

Weakness of the Bladder in Old Persons.- 

An inability to perfectly retain the urine, and a weakness of the 
bladder, is a frequent disorder of aged persons. It often 
commences with and is accompanied by imperfect emptying 
of the organs, either through carelessness or weakness. 
Sponging the lower parts of the abdomen, &c. &c, with 
vinegar and water, or salt water, may be of service. Some 
physicians recommend the use of the tincture of the ergot 
of rye in these cases, a teaspoonful three times a day, but as 
a general rule they should be placed under regular medical 
attendance. The same may be said of that very troublesome 
complaint of old age, catarrah of the bladder, in which large 
quantities of thick mucus are discharged. A tea made of 
uva Ursi and Buchu leaves (in equal parts), taken in the 
quantity of a small wineglassful three times a day, with the 
addition of twenty drops of spirits of nitre, is beneficial in 
diseases of this kind. 

Bil0 B — This is secreted by the liver, is a brownish-yellow 
color, and has a very bitter taste. Its composition is complex, 
and it undoubtedly fills more than one important function in 
the body. Bile is separated by the liver from dark blood, 
which, passing through that gland, on its way to the heart, 
from the abdominal organs, is thus purified of noxious mat- 
ters, containing a large amount of carbon, before re-entering 
the general circulation. The separated bile is discharged into 



438 biliousness, or Biliary Derangement. 

the duodaLim (top of the bowels), and mixing with the di- 
gested food, appears to assist in fitting certain of the constitu- 
ents for absorbing into, and assimilation or transformation in 
the body. A large proportion of the constituents of bile are 
along with the food re-absorbed into the system, and are 
probably intended and adapted to support the processes of 
re3piratory combustion in the lungs. It is chiefly the color- 
ing matter of the bile which is discharged from the bowels in 
health, which gives color to the discharges from the bowels. 

BHHousness or Biliary Derangement.— 

When persons feel unwell and do not exactly know what is the 
matter, it generally turns out they have made up their minds 
that they are "bilious I" It is true that biliary disorders are 
very common. In fact biliary derangement is so frequent an 
ailment in civilized life — its history is so intimately connected 
with the general principles of health, and the prevention, 01 
at least alleviation, of the disorder is so much under indi- 
vidual control, that it has special claims upon our attention. 

It has been shown, under the subject of Bile, that in 
ordinary health there must be a certain balance maintained 
between the secretion and ultimate destination of the bile, the 
Aisimiliation of food, and the functions of respiration ; that 
i:i the excreted bile the blood is freed from certain principles 
containing a large amount of carbon, which could not be 
retained in it without injury to health. That further, the 
bile having been separated from the blood by the liver, and 
thrown out into the general tract of the bowels, performs an 
important part in the function of assimilation (digestion) ; 
and that lastly, a considerable proportion of the bile — with- 
out the coloring matter — is reabsorbed into the system, with 
the nutriment, in such a state as to fit it, or rather its carbon, 
for union with the oxygen which enters by the lungs, so that 
while heat is generated, the carbon, by taking the form of 
carbonic acid, is fitted for excretion by the lungs or skin. 
Upon these facts hinge the causes of one at least of the most 
prevalent biliary disorders, that which depends upon the 
introduction into the system of a proportion of carbon ali- 
ment too great to be removed by the oxygen obtainable 
through the lungs, and which has its ordinary termination in 
the attacks which are termed " bilious attacks," " sick head- 
aches," "bowel complaints." " cholera morbus," &c, according 
to the manner in which the patient is affected. 

The second form of biliary disorder depends upon torpidity 
or inactivity of the liver itself. The third form is' the reverse 



Biliousness, or Biliary Derangement 439 

of the first : the gland itself may be sufficiently active, but the 
blood does not afford sufficient material to work upon, and bile 
is deficient. This is most frequent in children. 

The first form of biliary disorder, that dependent upon 
the accumulation of carbon, or of the elements of bile in the 
blood, must evidently be owing to one of the following causes, 
or a combination of them ; either too much food, espec- 
ially of a highly carbonized character, such as fats, oils, 
sugar, &c, is habitually consumed, or the habits are too 
phy^cally inactive to keep the functions of respiration 
animal heat, and circulation, in healthy action, or the 
external atmosphere is so tempororily or permenantly rarefied 
by heat that the individual cannot obtain the full supply of 
oxygen in respiration ; lastly, the excretory function of the 
skin, (sweating, &c), may be impeded. Sow, though it is 
unquestionable that some persons have a much greater ten- 
dency to biliary disorder than others, it is also unquestiona- 
ble that all have in their power in a great degree, if not 
entirely, to control or obviate that tendency, by attention to, 
and practical application of, the above principles. In those 
who suffer habitually from sick headaches — which depend 
generally upon the presence of bile in the stomach — and from 
other forms of biliary disorder, there is generally traceable 
great error in diet. Fats, as found in ham and bacon gener- 
ally, melted butter, pastry, meat, malt liquors or wine, and 
other highly carbonized articles of diet, are taken too freely, 
or at least are too regularly indulged in, while at the same 
time very little active exercise is taken; the blood becomes 
overloaded with carbon; languor, sleepiness, headaches, giddi- 
ness, loss of appetite, furred tongue, depression of spirits, are 
the consequences, and continue until at last the system is 
relieved, wholly or partially, by an excessive secretion of 
vitiated bile, which passes off either by vomiting or purging. 
That deficient exercise has much to do with such a state of 
system, is evident from the much greater prevailance of such 
attacks among females, who take little exercise, than among 
men ; and indeed they would be still more prevalant among 
the former, were it not for the monthly sickness. Habitual 
neglect of the skin, also, by impeding the excretion of car- 
bonic acid from its extensive surface, undoubtedly assists the 
evil. 

From what has now been said it is evident how much the 
avoidance of biliary disorder is under individual control; 
the question is in reality not one of medicine, but of diet and 
regimen / medicine certainly may be required, but not by any 



440 Sciatica. 

means to the extent it is often used. Those who are habitually 
liable to biliary disorder onght most strictly to regulate the 
diet ; fats of all kinds (except, in some cases, bacon,) must be 
avoided ; butter either entirely avoided, or used in very small 
proportion, and never when melted ; animal food may be 
taken il moderation, but should never be consumed at night / 
much sugar, strong tea or coffee, malt liquor and wines, are 
all bad. In addition to plain meat, bread, well boiled vege- 
tables, farinaceous preparations, such as rice, potatoes, &c, 
and fruits, ripe or cooked, are the best articles of diet. 
Exercise regularly in the open air must be taken, and the 
skin kept clear and in an active state, by frequent bathing, 
friction, &c. If the bowles are confined, a pint of warm 
water, used as an injection, will be most suitable. It is much 
better not to trust to medicine. When, from any cause, the 
languor, sleepiness, furred tongme, &c, give notice of an 
impending billious attack, eat sparingly of the mildest diet 
and take a purgative of some kind. Having thus cleared the 
system, it is better to trust to diet and regimen than to a repe- 
tition of the dose as a corrective of indulgence. There is rea- 
son to believe that an emetic of ipecac or warm water taken 
on the first approach of the disease, would break it up suddenly 
in most cases. 

SciOtiCda — This is a kind of Neuralgia or Nervous 
Rheumatism^ which effects the Sciotic nerve, the great nerve 
of the lower extremities. This nerve, the largest in the body, 
passes down the back of the thigh to the ham, a little above 
which it devides into two main branches. The nerve some- 
times becomes the seat of severe neuralgic pain, felt down its 
entire course, or perhaps in the hip only, or sometimes in the 
foot and ankle ; the pain comes on in paroxysms, and is gen- 
erally increased by exercise ; in some cases pressure upon the 
courses of the nerve causes pain. 

Sciatica is often attended with so much suffering, that it af- 
fects the general health to a considerable degree ; moreover it 
is frequently most difficult to get rid of. Leeches and cupping, 
in the first instance, down the course of the nerve, especially in 
phietoric, robust subjects, followed by blisters, are useful; 
or heat and moisture may be used with advantage in the 
form of a bran poultice, followed twice or three times a day 
by the application of a liniment. Kerosene oil frequently 
applied is an excellent application, to be followed by lauda- 
num and turpentine, well rubbed in, and then covered with 
flanneL 



441 

The bowels being cleared by a purgative, if there is no ten- 
dency to fever, drachm doses of carbonate of iron, given three 
times in the twenty-four hours, often cures quickly ; or tur- 
pentine, in doses of fifteen drops, given in milk, three times a 
day, may be tried ; or quinine, in two-grain doses, every eight 
hours. There is considerable uncertainty in the effect oi 
remedies in Sciatica, even in skillful hands. Jn all cases of Sci- 
atica, perfect rest of the limb is essential. Sulphur baths are 
also recommended. 

Gonorrhoea, As this book has been written 

for all classes, a short statement giving the symptoms, causes, 
treatment, &c, of the various forms of sexual, or (as they are 
usually called.) venereal diseases, is necessary. In the first 
place, it should be understood, that Gonnorrhcea, or Clap, 
and the Venereal disease, are two entirely distinct diseases. 
A person, for instance, having Gonorrhoea cannot give 
another person the Venereal disease, nor can one having the 
Venereal disease give another the Gonorrhoea, or Clap. 
Neither can one disease change into the other ; but both dis- 
eases may exist in the same person at the same time, and 
both may be communicated at the same time, or only one, 
as may happen. The important point to condder is that they 
are two distinct diseases. This is very important, because 
Gonorrhoea is simply a local disease, while the Venereal 
disease, or Pox, is a constitutional disease, which poisons the 
blood. This is an infectious disease ; it is seated in the uri- 
nary passage, from the orifice of which there issues a dis- 
charge of matter, attended, more or less, with pain and heat 
in making water. There is no outward sore or ulcer in 
Gonorrhoea ; neither is there any within the passage. If it 
were possible to take an inside view of the urinary passage, 
nothing would be seen there but redness and a little swell- 
ing, and the discharge, whether much or little, would be seen 
issuing from the red and swollen state of the membrane 
which lines it, just as matter is sometimes seen issuing from 
an inflamed eye. Venereal disease, on the contrary, is not 
seated in the urinary passage, but externally, on some part 
or other of the genital organs, and consists in one or more 
little ulcers or sores, which do not heal like others, but con- 
tine unhealed, and, at length, assume a peculiar character. 

Gonorrhoea consists in a discharge from the urinary pas- 
oage, attended, more or less, with pain and heat in making 
water, without ulceration or sores ; whereas Venereal disease 
consists in external ulceration or sores, without discharge 



4*2 

froifl tfif£ urfriaff jMs^age, and without paiifor lieat in making 
water. No one, it is presumed, after this can possibly mis- 
take these two diseases. 

A person having been exposed to this infectious malady 
(Gonorrhoea), at some period within seven days, if he should 
have taken the disorder (which we will suppose to be the first 
attack), will feel a little pain and heat in making water. This 
leads him to make an examination, when he will find the orifice 
of the urinary passage looks a little redder than usual, its lips 
rather pouting or swollen, and on squeezing it, an uncommon 
dampness or thin mucuous will be seen. In the course of a 
few hours, or by the next day, the pain and heat in making 
water will have increased, the discharge also increased and 
of a purulent or white creamy appearance. For some days 
these symptoms go on increasing in severity, the matter be- 
coming of a yellowish color. Sometimes the pain and heat 
in making water will be exceedingly great, amounting to a 
sensation of absolute scalding; at this time the discharge 
generally turns to a greenish color, and instead of being about 
as thick as cream, is thin and watery. Under these circum- 
stances, there is also a painful sensation along the whole 
length of the urinary passage. Gonorrhoea always begins 
with pain and inflammation, more or less, which after a 
time abates very much or entirely subsides.. This is called 
the inflammatory stage of the stage. 

The degree of pain and inflammation is not the same in all 
cases ; the oftener a person has had the disease, as a general 
rule, the less will be the inflammation, so that persons who 
have had the disease several times may feel scarcely any pain, 
the only notice of it being the soiling of the clothes with 
matter. After a time this inflammation subsides, whether 
remedies have been used or not. 

In the commencement, the seat of gonorrhoea is just within 
the orifice of the urinary passage ; but the disease soon pro- 
gresses, until it reaches the neck of the bladder. How long 
a time it may occupy in its passage through the urinary canal 
is uncertain, and differs in different individuals, ana under 
different circumstances of constitution, mode of life, etc. The 
painful inflammatory symptoms, however, seem principally to 
attend the invasion of the disease,- and most of all, its ef- 
fect upon the first portion of the passage ; when these are 
subsided, we may consider it has advanced to its ordinary 
distance. 

After a time, or if there has been much pain, after this haa 
subsided, another stage of the disease commences. This stage 



443 

consists simply of an infectuous discharge issuing from the 
orifice, with little or no pain. This discharge is more or less 
in quantity in different persons, and is much increased by 
whatever may excite, or by irregularities of any kind. This, 
especially when the discharge is slight, and quite unattended 
with pain, is what is properly called " Gleet," and when once 
suffered to commence, there is no telling how long it may 
continue, or how it is to terminate ; but let it ever be remem- 
bered, that, as long as this discharge continues, the disease 
may be communicated by infection. This, then, is the Second 
or Chronic Stage of Gonorrhoea. Sometimes there is great 
swelling of the foreskin and prepuce, which is not free from 
danger as mortification sometimes takes place, on account of 
a kind of ligature being formed of the skin around the parts, 
called Phymosis when the skin cannot be brought back, and 
Pariphymosis when it cannot be brought forward. Swelling 
of the glands in the groin, which often takes place, is the re- 
sult of inflammation. 

In every part of the body, there are certain little vessels, 
called absorbents ; and these, in their course, run through 
absorbent glands, of which there are several in each groin. 
Now it happens that inflammation in the urinary passage is 
communicated through the medium [of these vessels to the 
glands in the groin, which become painful and enlarged in 
consequence. It is, however, worthy of remark, that in gon- 
orrhoea, glandular swellings seldom go on to form an actual 
bubo (which is an abscess in the groin), as they are apt to do 
in Venereal Disease, so that they are comparatively trifling ; 
after a little while, they generally subside and disappear. 
Swelling of the testicle sometimes take place, and generally 
the pain is great, and the necessity of rest and lying in bed 
is urgent. Much, however, may be done to prevent it, if early 
attended to, and therefore the symptoms which precede and 
lead to it should be noticed carefully. 

The first thing which precedes a swelling of the testicle, is 
a sense of pain running down the whole length of the urinary 
passage, accompanied with a feeling as if a drop or two of 
urine were remaining in the passage after making water. To 
this there succeeds a dull pain in the groin, going on to affect 
the testicle, which presently feels heavy, and very tender to 
the touch ; or, the pain and tenderness of the testicle may set 
in at once without any of these premonitory symptoms. 
No time should be lost. It should be attacked instantly, in 
order, if possible, to arrest the inflammation before fall/ 
developed. 



444 

Inflammation of the Bladder is sometimes caused by gon- 
orrhoea. It may be slight, causing merely the inconvenience 
of too frequent urinating, with difficulty of restraining it, 
or, the bladder may empty itself every five or ten minutes, 
passing only an ounce or two of highly-colored urine, with 
great pain, and followed by blood, the desire to urinate remain- 
ing unrelieved. It is then attended with fever. This affection 
oftener appears in a mild or sub-acute form, but may set in 
with great severity, and is then a most painful and harassing 
addition to the gonorrhoea. 

The question is sometimes asked, " Does gonorrhoea ever 
wear itself out 2" It may possibly do so ; but it is running 
a; most terrible risk, for it may, in the meantime, produce 
gleet, and stricture of the urethra. 

It is a serious matter for a physician, in writing a book for 
the use of the massses— those who are not conversant with the 
many phrases used by medical men in their every day pro- 
fessional life, to attempt to give definite and complete 
directions for treating diseases of such a complex nature and 
dangerous tendency, as diseases peculiar to the sexual organs 
in both sexes. The reader may not — most likely will not—* 
have a Medical Dictionary at hand to consult, as to the 
meaning of various words in common use by medical men 
in describing the treatment and remedies to be made use of— 
and under such circumstances is just as likely to take the 
wrong meaning as the right — and the consequence is, the 
disease is made worse instead of better, and finally, after much 
suffering — possibly some local injury that will follow the 
sufferer to the grave — he goes to a physician for treatment. 

Besides all this suffering and the risk of permanent injury, 
the expense — no trifling matter to most of people — would in 
all probability be as ten to one. 

We remember a case of this kind : A young man who held 
a very responsible position in a large city South, was so un- 
fortunate as to contract Gonorrhoea ; he was married, which 
made his case the more lamentable, and in his efforts to con- 
ceal his adulterous and unmanly conduct, he tried the reme- 
dies which he found recommended in some popular medical 
work ; the result was, that after long, weary weeks of suffering 
— dirting, purging, and using a lot of medicine, better adapted 
to a sick horse than a sick man, and becoming fully satisfied 
that he could not cure himself— -he gave up his lucrative and 
honorable position, and came to New York. Falling in with 
one of the medical sharks that infest all cities, he was cured 



445 

of Ms money to the time of $150 ; but his disease was worse 
than ever, his body reduced almost to a skeleton, and hig 
mind worked up to the verge of despair. In this unhappy con- 
dition he happened to think of the author, an old acquaintance 
of other years, and finding his way to my office, out of heart, 
out of money, he told me his sad story. In about one month 
I had him so that he was able to say he was once more a well 
man, and went back to his home a wiser, if not a better 
man — having lost nearly a year in business, spent his money, 
suffered much in body and mind, before he found out that in 
diseases of this nature, a competent physician at the begin- 
ning is the cheapest and best investment a man can make. 

Treatment. — Live on low diet, avoiding meat for ten days. 
Take a dose of Epsom salts, or Rochelle salts, oneLDr two heap- 
ing teaspoonfuls in a glass of cold water, before breakfast every 
second morning for a week. Wash the parts thoroughly with 
Castile soap and water once a day, and bathe freely in cold 
water the parts affected three times a day. Take one heaping 
teaspoonful of powdered cubebs in a glass of cold water hall 
an hour before each meal, for four or five days. If not better, 
then use instead, the following mixture: Balsam Copaiba, 
Spirits Nitre, Spirts Turpentine, of each three ounces ; essence 
of peppermint, one teaspoonful. Shake well before using, and 
take one teaspoonful before each meal in sweetened water or 
syrup. It may be necessary to change, first taking the cubebs a 
few days, and then leave off and use the mixture given above. 
The parts must be kept clenn. 

Swelled testicles is treated by absolute rest, free purging with 
salts or Rochelle and poultices, cooling washes — Sugar of Lead, 
two tablespoonf uls in a pint of water, to which add one teaspoon- 
ful of laudanum. Leeches may be necessary, and a Suspensory 
Bandage should be used until cured. 

In females, there is burning, smarting pain in the parts, made 
worse by urinating. There is also a numbness or heaviness of 
adjacent parts, down the thighs across the lower part of the 
back, the abdomen, etc. When these symptoms pass off, there 
is a discharge of matter similar to that witnessed in males, and 
which may gradually run into Chronic Whites. 

Treatment consists in free and frequent bathing in cold water, 
or cold green tea, and fully cleaning the parts with soap and 
water and keeping them clean. Sometimes females have 
"Whites," and will give a disease to the male resembling Gron- 
orrhcea, and in married life often has caused much unhappi- 
ness, although the wife may be entirely innocent 



m 



SYPHILIS, OB VENEREAL DISEASE. 

Syphilis. — This disease, as we have before stated, ia 
an entirely distinct disease from Gonorrhoea. It commences 
with minute erosive ulcers on some parts of the genital 
organs. These are termed chancres. As the chancres gra* 
dually spread and deepen, they secrete a virus, which, being 
absorbed, may occasion a constitutional taint or cachexy, 
called secondary or constitutional syphilis. The first stage of 
a chancre is called the vesicular. A small red point is first 
noticed, which soon becomes elevated into a pimple ; this is 
gradually changed into a vesicle or sac, containing a turbid 
humor covered by a scab, which is eventually detached, 
becoming an open ulcer. The time elapsing from the first 
appearance of the morbid point to the complete ulceration, 
may be a few hours, or several days. 

The second stage is that of ulceration. The sores are 
generally of a roundish form, involving the whole skin and 
the adjacent parts with an indurated (or hardened) base and 
edges. The size of the ulcerated surface varies from that 
of a pin's point to a dollar. Sometimes the centre and bor- 
ders of the chancre are elevated so as to form a fungous 
(proud flesh) projection, constituting what is called the 
raised chancre. Chancres in close proximity often become 
united into a single ulcer. This stage of ulceration may last 
for several weeks or months. In some cases it has continued 
for years. 

The third stage is that of cicatrisation (or healing). When 
a chancre is about to heal, it passes into the condition of a 
wound. The difference between an ulcer and a wound con- 
sists in the difference of the membrane secreting the humor 
which covers the two solutions of continuity. When this 
cicatrizing membrane appears, the edges of the ulcer which 
are detached sink, and approach the base, to which they unite, 



447 

The inequalities of the base, the indentations of the borders, 
disappear, and are replaced by fleshy granulations (or healing 
points), resembling those in suppurating (running) wounds. 
As the healing of the ulcer progresses, its circular form 
becomes changed and angular at several points of its circum- 
ference, because its edges are drawn inward, and in an unequal 
manner, by the membrane. The cicatrix (or scar) which suc- 
ceeds to chancre, like that of every solution of continuity 
with loss of substance, is shrivelled and depressed ; sometimes, 
instead of being depressed, it is, on the contrary, elevated 
like a honeycomb. On the mucous membrane these marks 
at length completely disappear. 

Once the healthy process commences, its progress is rapid, 
for it is now no longer that of a chancre, but a wound. Cic- 
atrization is not complete while there remains a single point 
of the grayish base. This point may extend, become devel- 
oped, and the chance itself be renewed ; or, to speak more 
correctly, become enlarged, and invade the cicatrized portion, 
and the adjacent integuments, which were not before attacked. 
But when the cicatrization has once covered the whole sur- 
face, a return is no longer possible ; before another chancre 
can appear, there must be a new inoculation — another attack 
of the disease. 

The chancre, as described in the preceding article, is called 
regular. "When the sores extend irregularly, and progress 
rapidly over the surface, in the form of a malignant erysip- 
elas, they have been termed phagedenic. The term chancre 
signifies a gnawing, corroding atfection ; but the disease is 
denominated phagedenic only when it is unusually erosive, 
irregular, and spreading. 

Another form is called gangrenons. It implies a destruc- 
tion or death of small portions of tissue beyond the boundaries 
of the ulceration. The phagedenic and gangrenous varieties 
do not depend on peculiar modification or virulence of the 
original affection, but on the morbid conditions and habits of 
the patients themselves, or upon the unfavorable circumstan- 
ces in which they are placed. 

Another variety has been denominated dijptheritic or pul- 
taceous. It is generally noticed in old and feeble persons. 
The ulcer is deeply colored, disposed to bleed, and the sur- 
rounding tissues are thickened and indurated. The ulcer is 
coated with a false membrane, and bleeds if this is removed. 
This membrane or coating is, however, immediately repro- 
duced. In some cases, the ravages of the disorganizing pro- 
cess are terrible. The genital organs are rapidly destroyed 



448 Syphilis, or Pox. 

and the adjacent parts often present a disgusting mass of corrup- 
tion. The indurated chancre is defined as a small, round, cal- 
lous ulcer. The first thing to be done is to heal up the sores, 
or chancres, by the application either of bluestone (sulphate of 
copper, blue vitriol), or nitrate of silver. A stick or piece of 
bluestone inserted in a goose quill, or any similar contrivance, 
should be moistened with water and applied to the sores every 
day until cured. A simple piece of dry lint being applied all 
the time to absorb the discharge, and which should be fre- 
quently changed in the twenty-four hours. 

Or, if you decide to use nitrate of silver (lunar caustic), apply 
the solid stick, moistened in water, once every two days. It 
should be applied thoroughly to every part of the chancrous 
surface which exhibits the least trace of the grayish or yellow- 
ish, or dusky white matter. A thin film or pellicle instantly 
forms over the surface, which is cast off in a day or two, when 
the caustic should be reapplied if there is the least appearance 
of the erosive matter aforesaid. After a few applications — pro- 
vided the proper hygienic measures and regiminal directions 
are attended to — the ulcerated surface will present a smooth, 
florid, healing appearance, when the caustic may be dispensed 
with. Should the ulcer, however, at any future time, take on 
the virulent character, the caustic treatment is to be resumed. 
It sometimes happens that a large chancrous surface will pre- 
sent the appearance of healing granulations at some points, and 
the erosive action at the others. Here it is necessary to cauter- 
ize only the virulent points. The sore should be thoroughly 
cleansed with tepid water before the application of the caustic, 
and afterwards covered with a little dry lint. The lint should 
be kept in constant contact with the secreting surface, so as to 
absorb the matter, and very frequently changed, especially 
when the ulcer is large and the secretion of matter copious. 

Besides this local treatment, medicines must be used for the 
constitutional disease. Begin by giving three grains of blue pill 
once or twice a day, until the gums begin to get sore. Then 
leave off the use of the blue pill until all the soreness of the 
gums is gone ; then, say after about ten days, use the blue pill 
as before, until the gums begin to get sore the second time, 
when it should be left off altogether. In the meantime, a tea- 
spoonful or two each of cream of tartar and flowers of sulphur 
should be given in a glass of water once every one or two days. 
After this course of treatment, as a general thing, the patient 
will be cured. 



Gleet— Its Nature and Cure. 449 



GLEET.— ITS NATURE AND CUBE. 

A Gleet is almost always the consequence of a badly managed 
Gonorrhoea. Instead of following up the cure of that disease 
by the means which have been so particularly dwelt on proper r 
the discharge is suffered to go on from month to month, and 
the effect of this is to entail a permanent disordered condition 
of the parts affected, and which generally then goes under the 
name of Gleet, Weakness, &c. 

It is important to understand the nature of this malady as 
well as how to care it, especially as a very serious error re- 
specting its infectious nature prevails with many. It is a very 
common thing to hear it said that a Gleet is not infectious ; 
but this is very wrong, and often leads to great trouble. Vir- 
tuous and unsuspecting women are unintentionally involved in 
this complaint in consequence. A person who is about to 
marry, for instance, may not have had Gonorrhoea for six or 
nine months, or longer ; but a slight discharge — so slight indeed 
that he has scarcely observed it — may have continued all this 
time. But he does not dream of its infectious nature until the 
saddest consequences show themselves. So, also, unfortunately, 
does a similar cause of unhappiness frequently occur in those 
that have been abroad or from their family for a length of 
time. Indeed, the consequences of this error are so very 
serious that it merits any pains and trouble to set the matter 
in its own true light, and perhaps I cannot do this better than 
by giving a case or two as related by Sir Astley Cooper. 

On this subject, Sir Astley observes — u Gonorrhoea, when 
neglected, sinks into a Gleet, and is known by the change of 
the color of the discharge, and the pain attending the inflam- 
matory stage ceasing. In this state is the discharge infectious 
or not ? I doubt myself whether a Gonorrhoea ever loses its 
power of causing infection as long as any discharge from the 
urethra remains, and I will give you my reasons for this opinion. 
A married gentleman went to Lisbon from this country, 
[England] and whilst at a distance from home, departed, 
as too many do, from the path of virtue. The Portuguese lady 
with whom he cohabited gave him the Clap. He returned to 
England, and, after the expiration of five months and three 
days, after first observing the Gonorrhoea, he called on me, 
and asked whether he might return home with safety to his 
wife. He said he had a little discharge, and wished to know, 
If, after having it five months and three days, it were possible 
for it to be infectious. I replied — 'Certainly not ; you may go 



4:50 Gleet — Its Nature and Cure. 

home, tli ere is no danger of you giving it to your wife.' He 
went home, and unfortunately gave his wife a severe Clap. 
I attended both the parties afterwards, and was extremely 
sorry for what I had done ; but I thought, at the time I gave 
the advice, that a Gleet was not infectious. But I think 
differently now — and believe that, after a continuance of 
several months, the discharge is infectious." 

Another instance — " A gentleman from the north of Eng- 
land, who had been recently married, came to me and said 
that he had communicated a Gonorrhoea to his wife. Shocked 
at such an occurrence, I said, 'How could you think of acting 
in such a manner ? ' ' Why sir,' said he, 'for fourteen months 
prior to my marriage I had a Gonorrhoea; I made various at- 
tempts to get rid of it, and had a variety of advice about it, but 
a yellow discharge always continued. I was told by every- 
body that it was not infectious, and not till after such repeated 
assurances did I get married ; the consequence, however, is, 
that my wife has a severe pain in making water, and a copious 
discharge.' I visited her, and found her in this state; she was 
some time under treatment before she quite recovered. From 
what I have seen, I do hold that a medical man is not warranted 
in saying that a discharge of a gleety kind is not infectious." 

On these two cases thus faithfully related, then, every per- 
son may be able to form his own opinion on the infectious 
nature of a Gleet ; I think they are sufficient to make every 
reflecting, conscientious person take care how he gives advice 
in such a case, particularly if his patient is a married man. 
Indeed, it is from this error, or from a total indifference as to 
its consequence, that we have so many cases of Gonorrhoea — 
they are twenty to one compared with cases of Venereal. In 
fact the common women of the town pay no attention to a 
Gleet. After the first or inflammatory symtoms of a Gonorrhoea 
have subsided, they mix with society as though nothing ailed 
them. In the patients of the Hospital called the " Lock " in 
London, for instance, nothing is more common than to see the 
Venereal and the Gonorrhoea in the same female ; but it is the 
Venereal which brings them there. As to the Gonorrhoea, or 
Gleet, they will tell you they have had that a long time, and 
thought nothing of it, but having got the Venereal, in the 
form of chancres, they became alarmed, and anxious to be 
cured. So also, when the Venereal is cured, they seldom stop 
in the Hospital for the cure of the Gonorrhoea, or Gleet, but 
go out again promiscuously in the town and spread the Gonor- 
rhoea in every quarter. 

I do not however, after all, say that every Gleet is infectious 



The Treatment and Cure of Gleet. 451 

but, they are so generally, and there is no mark whatever by 
which it can be said that this one is infectious and that one is 
not — this can only be known by its consequences. How 
serious therefore to say to any one, especially to a married 
man, or one about to marry, that a Gleet is not infectious? 
But it is incumbent also to state, that there is a discharge 
from the urethra, in some measure resembling a Gleet, which 
is not infectious. A discharge of this harmless kind may 
proceed from two causes which may be easily understood. In 
the first place, it may proceed from a little abscess which 
occasionally forms in the urinary passage, and breaks; and the 
other is, a discharge proceeding from a Stricture. Now, the 
nature of these two causes of discharges must be understood, 
and then a supicious Gleety disorder will be easily detected 
and distinguished from either of these. 

First — With regard to the discharge from the little abscesses 
above mentioned, it should be known, that, in the whole 
length of the urinary passage are situated here and there, lit- 
tle sacks for the purpose of secreting a lubricating fluid ; these 
are called laeunce. After a Gonorrhoea, these little lacunae are 
sometimes affected with common inflammation, which forms 
into abscesses, and when these burst and their contents are 
discharged, the running ceases. Now, the circumstance by 
which these abscesses may be distinguished from a Gleet, is 
this : — the discharge from these lacunse stops entirely for a 
week or two, and then, when another breaks, it comes on 
again suddenly, and again ceases as before ; but the discharge 
from an infectious Gleet never stops — it may increase, from 
excesses or irregularities of any kind ; and it may decrease, 
so as to become very trifling, but it never ceases altogether. 
This, therefore, affords a good rule forjudging between Gleet 
and a discharge from these abscesses in the urinary passage. 

And next — With respect to the discharge arising from 
Stricture, this will be easily detected by considering the 
symptoms proper to Stricture. 

THE TBEAT3IEKT AND CUBE OF GLEET. 

A Gleet is often a very troublesome disease to manage. If 
there were no other reason for saying this, I might safely infer 
it from the numbers who have come to me with this complaint, 
having had it on them, more or less, for a length of time. 
These patients generally state that they have tried a great 
variety of means, and are quite disheartened. I cannot 
always learn particularly what these means have been, they 



452 Ihe Treatment and Cure of Gleet 

have always failed. As remarked, when treating of Gonorrhoea, 
etc., the best plan is to go at once to a good physician, but if 
you decide to treat yourself, we recommend the following : 

There is probably no disease of the sexual system, which so 
often disappoints the expectations of the physician, or discourages 
the patient, as Gleet. When supposed to be entirely cured, a 
very slight dissipation or irregularity may produce the symptoms 
afresh, unless it has been thoroughly cured. 

As a general thing, we must rely on astringent injections, 
such as sugar of lead, sulphate of zinc, about eight grains to 
the ounce of water ; infusion of oak bark (cold), strong green 
or black tea, used three or four times a day, changing them 
every three or four days. At the same time we should see to 
it that the bowels are kept free, and also avoid the use of all 
kinds of stimulating drinks, such as whiskey, brandy, gin, beer, 
etc., as they invariably make the disease worse. 

Masturbation. — In all ages of the world, of which we 
have any account, there has prevailed in the youth of both 
aexes a most destructive habit, by reason of which many lives 
are lost every year, besides in other instances the laying the 
foundation for disease and a debilitated condition, which the 
best efforts of a life-time do not counteract. This habit is 
known by the name of secret habits of youth,, or masturba- 
tion, and is one of the most prevalent and most universal of 
any that afflicts the human race. One reason why the vice 
or kabit is so very destructive to youth, is from the fact that 
U is continued in secret from day to day, and from year to 
rear, without a knowledge of its real consequences. There 
we very few parents who ever think to warn their children 
of the dangers of this habit, either by speaking to them, 01 
putting into their hands a treatise on the subject, and even 
uo all in their power to keep their children from getting hold 
of any books on the subject. This kind of false modesty haa 
been the cause of many a blooming youth filling a prematura 
grave ; and we hope to see the time when parents, teachers 
and guardians will treat those entrusted to their care with 
more confidence, and the exercise of better judgment. 

This habit, began in youth, is often continued many yean 
it is not always the result of initiation, or contracted by contact 
with those who indulge in the habit, but this is the cause ii 



453 

most cases, and one bad boy will ruin twenty good ones. 
There are those who think their children can only contract 
bad habits by contact, and among the rest the habit of mas- 
turbation, and think if they can keep their families from 
ricious company they are safe. This is generally true, but 
there are exceptions to the rule ; for no matter how strict a 
parent may be, the very innocence of a child makes him a 
ready tool for the designing, when they chance to fall into 
their company. This habit is oftener learned at school than 
elsewhere. 

The following are some of the consequences of this des- 
tructive habit : Consumption is often induced by this habit, 
by debilitating the system, and causing tubercles to be devel- 
oped in the lungs. Loss of memory is among the most com- 
mon effects produced by it. Insanity is sometimes produced 
by this habit ; the unusual and unnatural excitement produ- 
ced by the very frequent repetition of the act, sooner or later 
reaches the brain, the great nervous centre, unless abstained 
from; and this weakness continues in a ratio with the 
extent to which the practice has been carried, until it no 
longer controls the body, and there is lowness of spirits, a dis- 
position to commit suicide, restlessness, discontented mind, 
and an exceedingly unhappy irritability of temper, causing 
the patient to make himself, and everybody around him, 
unhappy. An uneasy, aching pain, heaviness, and weakness 
across the back and loins, is a frequent symptom, especially 
in the morning. Palpitation of the heart, shortness of breath, 
and nervousness, also result from masturbation. A nervous, 
aching pain in the head, bones and muscles, resembling rheu- 
matism, is a frequent consequence. By weakening the 
general powers of the system, such persons have not the ordi- 
nary powers of resisting diseases, and for this reason when 
they expose themselves to an atmosphere tainted with ordin- 
ary epidemic or miasmatic poisons, they are more liable to the 
disease. Stricture, or narrowing of the urinal passage, is pro- 
duced by this habit. 

In females, the following diseases are produced : Whites, 
falling out of the hairs and eyebrows, bad breath, loss of the 
natural voice, barrenness, falling of the womb, epileptic fits, 
ulceration of the neck of the womb, hysterics, a desire for 
leclusion from society, etc. The most frequent disease pro- 
iuced by masturbation in males, is called spermatorrhoea, oi 
nvoluntary emission during sleep. These at first are rare, 
happening once in the course of two or three weeks, and 
rakes plaee during a dream of a lascivious character. Thej 



454 Masturbation. 

soon becomes more frequent, and if accompanied by a dream, 
they do not wake the person, and, finally, they happen almost 
or quite without any sensation. 

Treatment. — In all cases, it should be borne in mind that 
the first step to be taken for the cure of this malady, is, at 
Q?ice and forever to abandon the pernicious habit. There 
must be no indecision or trifling turn from the evil of your 
way. But in a large majority of cases, even when the habit 
has been abandoned, the effects on the general system, to a 
greater or less extent, still manifest themselves : and the suf- 
ferers will require the best medical skill. Such cases occur 
generally in the young of both sexes, who will not consult 
a physician in their own neighborhood, much less the family 
physician ; neither will they let their condition be known 
even to the most intimate friend or relative, but suffer on in 
body and mind for years, after pining away with dread and 
fea^ whereas a statement of their case to a competent medi- 
cal man would speedily result in their being cured. 

The treatment of this disease will be of no avail unless the 
habit which produces it is abandoned entirely. It may be a 
hard matter to do this, but it must be done or he can not be 
cured. It will greatly assist the patient in his efforts to over- 
come this habit, to avoid all conversation or reading of books, 
etc., that are calculated to excite the imagination on such sub- 
jects ; and to go into the society of cultivated and virtuous fe- 
males ; also to cultivate a taste for music, and in short, occupy 
the time in some kind of occupation that will take the mind 
from off those thing?, which so often lead the young into trouble. 

Tonic medicines may be necessary, and good digestible food 
should be eaten ; keep the bowels regular, avoid sleeping on 
your back, and bathe the parts in cold water night and morn- 
ing. We would say to parents, do not let your children grow 
up in ignorance of the nature and danger of this insidious 
habit and consequent disease ; tell them of its dangers and ad- 
vise them to avoid solitude on the one hand, and the society of 
bad boys on the other. Too much mock modesty in this matter 
has done great harm in many cases. 



Hysteric JTiU. 4d5 

Hysteric Fits, or Hysteria— Is a peculiar affection, 
and is the source very often of much un happiness. A lit of 
nysterics may assume different forms, but, generally, the 
female becomes apparently, of a sudden, partially insensible, 
t may be, falls down, but more generally has suifieieut 
warning to seat herself on a chair. The eyes are closed, the 
ids tremulous, the limbs are stretched out, and spasmodically 
and suddenly contracted, at intervale- ; or there is violent 
Struggling, the chest heaves, the heart and vessel* of the 
neck beat violently, and the face is more or less flushed, 
*'requentlj the patient puts the hand to the throat and 
neck, as if to dispel some uneasiness, and not uncommonly 
gives utterance to incoherent or disconnected sentences, 
generally in a peevish or distressed tone of voice. In most 
&ases the power of supporting the body when seated, re- 
mains, unless it is worked off the chair in the struggles. 
At length the attack, having lasted for a longer or shorter 
period, from a few minutes to some hours, terminates, 
probably with a fit of sobbing and crying ; the patient 
recovers consciousnes, but is left exhausted and fatigued with 
the efforts and struggles, and, perhaps, falls into disturbed or 
heavy-snoring sleep. 

Such are the outward manifestations of a fit of hysteria ; 
but before it comes on, many patients complain of a sense of 
general oppression or uneasiness, with coldness or numbness 
of the limbs. Just previous to the accession, the character- 
istic hysteric " globus," or ball in the throat, is probably felt. 
It seems as if a ball commenced rolling upward in the bowels, 
generally from the lower left side, and as if it kept gradually 
ascending toward the throat, which it seems entirely to fill 
up, causing those sensations which induce hysteric patients 
so often to carry the hand to, and pull at the forepart of the 
neck or throat. During the continuance of a fit of hysteria, 
little either need or should be done, beyond preventing the 
patient hurting herself during the struggling. Cold water 
dashed upon the face may be useful, or it may be poured in 
a stream upon the head for a few minutes at a time ; a mustard 
piaster on the lower part of the neck may be applied. If there 
is much flatulence, a half teaspoonful of essence of peppermint 
in a wine glass of water will give it relief. It must be remem- 
bered, that in most cases, the patient is sensible of what la 
going on around, and may, in the excited state of the nervous 
lystem, be painfully alive to any unguarded or unfavorable 
opinions uttered by those in attendance. For this reason, it ia 
not to be recommended that, as sometimes is done, severe and 
riolent remedies should be proposed within hearing of the pa 



4:56 Clergyman 9 s Sorv Throat. 

tienfc, with the view of frightening her out of the fit. Such a 
eourse has had the opposite effect, causing an aggravation of the 
symptoms. This is a different thing from threatening severe 
remedies while the patients are comparatively well. Such a 
plan of treatment, it is well known, has often succeeded in 
putting a stop to the spread of hysteria (by imitation) through 
echools, or such like collections of young females. 

The exciting causes of hysteria are, remotely, whatever 
tends to exalt the influence of the nervous system. Among 
the moderately-fed and hard-working population in the coun 
try, hysteria is comparatively rare, but it is not unfrequent in 
servants who remove from the poor living of their own homes 
to the stimulating diet of a rich man's house. Most gene- 
rally, hysteria, although in some degree the result of consti- 
tutional tendency, is connected with debility, and irregularity 
of the usual conditions of female health — all these being ag- 
gravated by emotions of the mind, particularly those which 
are connected with the affections ; these, too, when in direct 
excitement, as well as inordinate physical exertion, which 
produces exhaustion of the nervous system, must be ranked as 
amid the most general directly originating causes of the hys- 
terical fit itself. But little can be done for this disease during 
the " fit ;" about the best thing to be done is to give an 
emetic or vomit of Ipecac, or if nothing better, drinking 
every few minutes of warm water, until vomiting occurs. 
Also injections of warm water or soap suds up the bowels, to 
produce an evacuation, is advisable. 

The attack is to be prevented by keeping the bowels open, 
avoiding overloading the stomach, and plenty of exercise — 
doing a good day's washing occasionally or scrubbing the 
floors being of more use, a great deal, than medicine. 

Clergyman's Sore Throat. — So called from the fact 
that it is oftener witnessed in ministers of the Gospel than 
©thers. It is a peculiar affection of the throat and organs oi 
voice, to which public speakers are liable. According to Mr. 
Macready, actors who have to assume feigned tones, are more 
liable to it from that cause. The seat of the disease is the 
mucous follicles (little lumps) scattered over the membranes 
of the throat, larynx (vocal box) etc., being extended to the 
latter from the former. The commencement of the disease 
is insidious; it begins with an uneasy sensation, as if there 
was something in the throat which required to be hawked 
op or swallowed down ; at the same time the mucous se 
cr^tion is viscid (tough). As the larynx becomes affected 



Frost-bitten Parts — Common Cold. 457 

the Toice is changed, becomes hoarse, unequal in tone, of 
quite extinguished ; there may be slight pain about the parts, 
nut not much cough in the earlier stage of the disease. All 
the symptoms become aggravated by cold, by vicissitudes of 
temperature, or by exertion of the voice in reading, speaking, 
&c. The above sources of aggravation are of course to be guard 
ed against, and the general health attended to ; but the cure of 
the disease, which consists chiefly in the repeated application 
of a strong solution of lunar caustic to the parts affected, must 
only be entrusted to a physician. Dr. Green, of New York, 
has the credit of first accurately describing the disease, and 
of prescribing the treatment above mentioned, which is yery 
successful. But when you do not have the opportunity of 
having that done, I would state that Medicated Inhalation, 
as recommended under the head of " Catarrh in the Head," is 
very beneficial in this disease, assisted by gargles of tar- 
water, strong green tea, cold water, &c, and the external ap- 
plication of kerosine oil to the throat till it produces pimplea 
on the skin, to be applied and re-applied if necessary. The 
Btooping position required by ministers who read their ser- 
mons instead of preaching them, is one great cause of this 
difficulty. The best plan is to do like Christ, the Saviour, 
did while on earth going about doing good, " preach from 
ihe heart" instead of talking from paper — it will be better 
for both soul and body, for preacher and for people. 

Frost-bitten Parts. — Usually it is the ears, toes, nose 
and fingers. In such cases, as in warming the body to avoid 
aching, the restoration to heat must be very gradual ; a limb 
has been frozen perfectly stiff, and by being rubbed in snow, 
afterwards in cold water, and very slowly warmed, its life 
has been preserved. The sudden application of heat never 
fails to occasion inflammation, and mortification quickly fol- 
lows. When the heat has been gradually restored, and action 
and sensation perceived, the part should be rubbed with spir- 
its (gin, whisky, or Bay rum), the patient be put to bed and 
kept comfortable, perspiration excited by warm drinks, and 
perfect rest enjoined until the effects subside. Bathing the 
leet in cold water night and morning, and afterward rubbing 
with a coarse towel or flesh-brush, will harden the feti, 
•gainst the effects of cold. 

Common Cold. — " What is best to do for a common 
told?" is a question often asked, and as it is one of the nioet 
prevalent ailments to which frail man is subject, we propos* 



458 Common Cola. 

answering the question in a common-sense way. The innab* 
tants of every climate are liable to take cold at diffeient sea 
eons of the year, particularly when the changes of the 
atmosphere are sudden. The persons most subject to thia 
disease are those of a delicate and irritable constitution, and 
whose employments expose them to sudden transitions fronr 
Jieat to cold. 

A cold is attended with a weight or uneasiness in the head 
fullness and oppression at the chest, a sense of distension an 
stopping up of the nose, followed by a secretion of thin mucou 
from the nose, watering of the eyes, soreness of the throat, 
cough, with expectoration of mucous, cold shiverings, suc- 
ceeded by flushes of heat, and pain in different parts of the 
body — very frequently the chest, 

This disease is not generally attended with danger when 
appearing in a mild form, and early precautions are used. If 
the symptoms should be highly inflammatory, and the consti- 
tution of the patient delicate and irritable, the most vigilant 
attention is demanded in order to arrest the progress of the 
disease ; otherwise the most serious consequences may ensue. 
It is by such neglect that two-thirds of the cases of consump 
tion and other pulmonary affections in this country, arise. 

When a person finds himself much indisposed from ex- 
posure to cold, he should at once confine himself to the house} 
use a spare, mild diet ; drink barley water with lemon juice 
in it, or any other warm diluent, or mucilaginous drinks, and 
particularly avoid eating or drinking anything stimulating. 
Previous to going to bed, put the feet in warm water for a few 
minutes, then wipe dry and rub them well with a flesh-brush or 
rough towel, put on the stockings again, and get into bed at 
once (between blankets being the best in cold weather) ; then 
from half to one teaspoonful of paregoric, and about an equal 
quantity of syrup of ipecac should be taken in half a cup full 
of warm tea of any kind. The following morning take a dose 
of Rochelle salts or Seidlitz powder, or some other good 
purgative. The mucilaginous drinks should be taken 
through the day. .Repeat the paregoric two or three night* 
if necessary. Any good liniment or a mustard plaster ap 
plied to the chest (front and back) and also the neck will b( 
of service. A violent fit of tickling cough may be relieved 
at once by taking a lard pill or gargling with a spoonful of 
melted lard, or sweet oil. The course of treatment above ad 
yised will cure the great majority of common colds, whei 
strictly followed. To avoid taking fresh cold, gargle th« 
throat with cold water frequently during the day, especiallj 



Common Cough.- -Propagation of Diseases, 459 

Defore going into the cold air ; bathing the neck in cold 
water is also a good remedy. 

Continued Common Cough.— This is generally the 
effect of a cold neglected, or improperly treated. Sometimes 
t arises from indigestion, or irritable matter in the stomach 
and bowels. 

A common cough ought always to be viewed as a serious 
disease, and should never fail to excite the fear and anxiety 
of the patient and friends. By early and vigilant attention to 
this disease, thousands of lives are saved which otherwise are 
destroyed by pulmonary consumption. As a general thing 
it will be found more advantageous to employ external than 
internal remedies. The bowels should be first attended to by 
giving two or three good purges, a day or two apart ; then rub 
the throat and chest thoroughly two or three times a day with 
some stimulating liniment ; the author has found the com- 
mon kerosine oil about the best. If it proves too irritating, 
omit it for a day or two or more, and rub the parts with 
sweet oil or melted lard. Red flannel should be worn next 
the skin if it can be tolerated ; if too irritating it can be lined 
with silk. In addition to this treatment I would advise Medi- 
cated Inhalation, by all means (see Catarrh in the Head). 
The diet should be nourishing, but be careful to avoid every- 
thing that disagrees with the stomach. Gargling the throat 
with green tea (cold) or cold water frequently through the 
iay and night is often beneficial. 

Propagation of Diseases by Infection. — "Is it 

Catching?" is a question very often asked by those whose 
kindly natures have prompted them to perform a Christian 
duty by " visiting the sick." To all such, and all others, the 
following remarks on the subject will be found important and 
interesting. Contagious diseases may be communicated only 
by actual contact of individuals, as in the case of itch, &c. ; 
by innoculation as in the case of cow pox ; or in addition to 
both or either of these modes of transmission, through the 
atmosphere by infection, as in the case of small pox, &c. 

This power of propagation through the atmosphere, does 
3C,t ; independent of epidemic and other influences, extend far 
wrn the patient. Certain circumstances influence the extent 
«/f contagious diffusion. Of these, the most distinctly ascer- 
tained are atmospheric impurities ; for it is ever observed, and 
we believe it may be predicated of every disease possessing tht 
property of remote contagion, that its contagious matter is pre 



460 Propagation of Diseases by Infection. 

5>agated to greater distances in a dirty, crowded, and ill-venti« 
Sated apartment, than in one of which the air is pure. The 
Same principle applies to articles of dress and furniture ; those 
which are contaminated by animal secretions and effluvia 
being much more readily impregnated with contagious mat- 
ter than those which are clean. Peculiar atmospheric condi- 
tions, certainly, also favor the propagation of disease by 
contagion ; sometimes these conditions are inappreciable, at 
others they are evidently connected with a superabundance 
of warmth and moisture, and also, we have good reason to 
conclude, with certain states of electrical disturbances. The 
discovery of the new agent, or modification of the known 
existing agent oxygen — named ozone — may probably shed 
«ome new light upon the subject of contagion. Actual contact, 
however, or even immediate vicinage, to a person laboring 
under a contagious disease, is not requisite for its propagation 
to others. This may be effected by means of substances to 
which the contagious matter clings. These substances, which 
go by the name of fomites, are more generally clothing and 
stuff furniture which have been about or near the bodies of 
those laboring under the disorder. These fomites are apt to 
be impregnated with the poison in a very concentrated con- 
dition, and are capable, not only of retaining it for a long 
period, but of transporting it from place to place. A sofa on 
which a patient laboring under scarlet fever had lain has been 
known to propagate the disease six months afterward ; and 
clothes which have been about the sick are constantly ascer- 
tained to have been the medium of conveying fever, &c, to 
distant localities. Wool and cotton seem particularly apt to 
attract and retain contagious emanations; but, indeed, all 
loose textures have the property ; while on the other hand, 
polished and hard surfaces and substances are much less likely 
to act as fomites, if they do so at all. Everything of unne- 
cessary drapery or clothing should be removed from the 
chambers of those sick of contagions maladies, or indeed of 
any malady ; for a sick chamber must always, in a lesser o* 
greater degree, have an atmosphere containing unhealthy 
emanations, which it is expedient, both for the good of the pa 
tient and of others, should find no unnecessary attractions or 
lodgments. Further, it is advisable to have the furnitare aa 
much as possible of hard and polished substances, and the 
dresses of those in attendance upon the sick, especially if ha 
bitually so, might with advantage be made with a glazeQ 
surface. Those substances which have necessarily become 
the fomites of contagious matter ought to be scrupulous!/ 



Propagation of Diseases by Infection. 461 

freed from it by complete and lengthened exposure to the 
open air, by washing, or by exposure to the fumes of chlo- 
rine in a close apartment ; or by all three, the chlorine fumi- 
gation being first resorted to. Those persons under whos€ 
management a case of contagions disease has occurred, ought, 
as a Christian duty, to make sure that every article of stuff, 
furniture, clothing, &c, has been fully and carefully purified 
before others, either in the way of social intercourse or in 
occupation, particularly the washerwoman, come in contact 
with them. The following systematic course of action should 
be pursued when the generation of contagious matter hai 
ceased in an apartment, either by the death or recovery cf 
the patient, premising, of course, that throughout the illnesi 
measures have been (or ought to have been) resorted to to 
preserve purity. During the day, the door being shut, the 
windows should be open to their full extent, and the infected 
articles freely exposed to the air ; during the night, the win- 
dows and door being closed, chlorine should be well diffused 
through the apartment. This having been repeated, if possi- 
ble, for two days and nights, all textile fabrics and the like 
should be removed ; those that are capable of being washed 
put into cold water, and the others placed in the open air. 

All articles of furniture left in the room, also the floor and 
oil-painted wood-work, should be well scoured. If the cham- 
ber be a whitewashed or colored one, it should be " re-done ;* 
if papered, it is only a safe precaution to re-paper it. The 
bed requires the greatest amount of care ; if of wool, it ii 
better destroyed altogether ; if of hair or feathers, these 
should be exposed to the heat of rebaking, that is, at least to 
a temperature of 210° Fahr. ; and the ticking either tho- 
roughly fumigated and washed, or entirely renewed. These 
directions may appear minute and troublesome, but they are 
far from being too much so when put in comparison with the 
fearful scourge of a contagious disease which has established 
itself in a household or community, and which perhaps 
might have been checked at the outset by the adoption of 
prompt and vigorous measures. The poor and the ignorant 
cannot or will not adopt, in most instances, effective precau- 
tions ; it remains for the rich, for the well-informed, to point 
out their necessity, and lend a helping hand to their fulfillment, 
not only as an act of Christian charity, but as a means of 
safety for themselves. It is not a necessary character of con- 
tagious disease that it has itself sprung from contagion ; some 
of the most virulent and spreading fevers, such as those of 
the ship, or of the old jails, had no such commencement, but 



462 



Convalescence, or Getting Well. 



had their origin in the decomposing emanations from th, 
bodies of numbers of individuals confined in unventilated ana 
insufficient spaces. In addition to the disinfectants already 
mentioned — air, water, and chlorine — many others are and 
have been used, stich as the vapor of vinegar, of pitch, of to 
bacco, or camphor, or burnt sugar ; large fires also used to 
be a favorite method ; but none of these last mentioned are 
to be relied upon solely. The vapor of muriatic acid and 
the absorbing properties of newly-slaked lime, may be re- 
torted to, in the absence of chlorine, with advantage. In 
many instances, particularly in the case of clothes and other 
textures that will not wash, heat might be used more exten- 
Bively than it is at present as a disinfectant. A little trouble 
or labor in time may save much suffering and many lives. 

Convalescence, or Getting Well. — This is often a 
time of peculiar trial to the attendants upon the sick, and 
what to do, and how to do it, are matters of great importance. 
The commencement of convalescence, or the point at which 
the characteristic symptoms of disease cease, is sometimes 
distinctly marked, more especially after acute disorders ; fre- 
quently, however, the tendency toward health, particularly 
after chronic disease, is much more insensibly established. 
In the latter case, too, the progress of the convalescence is 
slower than it is in the former. Its rapidity or protraction 
is much influenced by age, and the nature and treatment of 
the previous malady. Children convalesce rapidly, old peo- 
ple the reverse. In no case, perhaps, is convalescence more 
tardy and unsatisfactory than after illness, in which much 
loss of blood, or of its constituents, has taken place. 

When convalescence from acute disease commences, the 
previously quick pulse falls to the natural standard, the 
tongue begins to clear, the skin becomes cool, sleep is refresh- 
ing, the mind acquires a more healthy and hopeful tone, and 
the person looks better. There is nothing which more assures 
a physician of the condition of hit patient than the look, the 
expression of the countenance, to which the first glance, as 
he enters the room of sickness, is almost instinctively directed. 
The look of convalescence is tranquil and placid, net the 
heightened color and bright eye of hectic, which so often 
deceive the inexperienced with delusive hopes. When the 
brain has been much affected, however, the condition of the 
mind, and consequently the countenance, as£umes its natural 
took more slowly. 

The management of convalescence is extremely important 



Convalescence, or Getting Well. 468 

Eirors in this sespect frequently expose the already-weakened 
patient to attacks of other disorders, or induce relapses to the 
diseased actions which had just been cast off. The convaies- 
cence after some particular diseases is more liable to such 
accidents than it is in others. That after fever is peculiarly 
so ; and after scarlet fever, the tendency to cold and its con- 
sequences, dropsical swelling, and affection of che kidneys, ii 
bo very common, and so frequently fatal, that the greatest 
possible care is requisite. During convalescence from acute 
disease, and especially of an eruptive character, many of the 
disorders characteristic of the scrofulous constitution show 
themselves : the eyes become the seat of chronic inflamma- 
tion, purulent discharge from the ears occurs, and chronic 
eruptions show themselves upon the skin, of the head espe- 
cially. These disorders, now, perhaps, for the first time ap- 
parent, are apt to continue even after convalescence, pro- 
perly so called, is over. Relapse in convalescence often 
occuis from too soon employing actively the previously affect- 
ed orgAD ; the liability to this mishap must be evident to the 
common sense of every one. In the case of the eye, it is evi- 
dent to the senses, after inflammation of that organ, its undue 
csercise, or even its exposure to full daylight, will often be 
followed by a return ot the disease. Such is the case else- 
where ; and whether it be the eye, or the brain, or the stomach 
which has been affected, return to the ordinary exertions of 
health must be made with the greatest caution. 

The clothing of a convalescent patient requires particular 
attention ; there is much susceptibility to cold and to at- 
mospheric vicissitudes. General exercise is to be resumed 
cautiously, and should never be carried to the extent of fa- 
tigue. Diet, however, is the great source both of error and 
mischief — the greatest difficulty which the physician has to 
contend with ; that is, in getting it properly attended to, and 
his orde>*s properly carried out, particularly among the poor. 
While a dise'*'.»e is in progress and alarm is felt, directions are 
tolerably weU, or strictly, obeyed ; but no sooner does the 
patient b«^rin to get better, than irregularities commence. 
The popular idea seems to be that convalescence must advance 
in proportion to the amount, and often to the stimulant quali 
ties, of the fcod given ; and many a hopeful case sinks back 
into fatal relapse from the willful and injudicious kindness 
of friends. The point is one which requires to be strongiv 
enforced, that in diet, as in everything else, convalescence 
must be gradual, and that nothing is more dangerous, more 
likely to induce relapse, than the injudicious use of solid ani* 



46 1 Falling out of the Hair, or Baldnes*. 

m*l food or of stimulants. Milk, and the various farrnaeioai 
preparations with which it is usually combined, such a* 
arrow-root, sago, rice, bread, &c, is perhaps the most gene- 
rally useful article of diet in convalescence ; next come the 
broths made from fowl, mutton, veal, or beef, alone, o* 
mixed with crackers or bread ; next in succession, are 
eggs lightly boiled ; aud lastly, solid meats, of which tender 
mutton is probably the best, are to be permitted. Ripe 
fruits in their season, if not contra-indicated by the nature of 
the previous disease, and if they do not occasion flatulence 
or diarrhoea, are both grateful and serviceable. The patient 
must be careful not to overload the stomach on any account. 
In whatever form nourishment is given to the convalescent, 
it should be in small quantity at a time, but as frequently re* 
peated as the natural appetite requires. The atmospheric 
purity of the chambers occupied by persons recovering from 
sickness requires great attention, and the temperature ought 
to be kept as nearly as possible about 58° Fahr. Lastly 
when convalescence has reached a certain point, there is no 
remedy which so surely promotes perfect recovery and con- 
firms health as change of air; but care must be taken that in 
so doing there must not be injudicious exposure during un- 
suitable weather. 

Falling out of the Hair, or Baldness.— Those 

who lose this great natural ornament before the " head is 
whitened over with the frost of many winters," feel the loss 
very keenly, as well they may, for the hair is not only orna- 
mental but useful. Falling of the hair occurs from weak- 
ness, either of the body generally, or of the hair-bulbs, or 
" follicles," themselves, various local stimulant application* 
are used in such cases, of which Balsam of Peru — a drachm 
stirred well into an ounce of simple cerate when melted — ii 
said to be a good application. 

Baldness, or loss or deficiency of the hair on parts usually 
covered by it, is sometimes seen in infants. It frequently 
occurs in adults of the male sex, even in the prime of life. 
and almost universally, in a greater or less degree in old age. 
The direct occasion of baldness is defect in the hair follicles 
from which the hair is developed ; and this defect may arise 
from diseases affecting the skin itself, from acute genera* dis- 
ease, as fever; or chronic constitutional disease, such as con- 
sumption ; it may also arise from constitutional peculiarity 
or the diminished circulation of blood, such as occurs in ad 
ranced life. Some families appear to be peculiarly liable tc 






Falling out of the Hair, or Baldnes* 465 

fewome the subjects of baidness, even in early life ; those 
who peivpire much about the head are often bald. Generally, 
however, whatever occasions a diminished supply of blood to 
the scalp or skin, gives the hair a tendency to shed, and th<s 
treatment must be directed to stimulating the skin as much as 
possible by proper and timely applications. After acute di* 
ease, if the hair falls off, shaving the part two or three timet 
(n succession will probably strengthen the growth, hi other 
Cases, much covering upon the head, which causes perspira- 
tion, and consequently weakens the skin, must be avoided; 
and the head should be well washed with cold water every 
morning, and afterward rubbed and brushed to promote reac- 
tion. Various applications are recommended to prevent or 
cure baldness; they are all stimulant. Those of which can- 
tharides, or Spanish blistering flies, form an ingredient, are 
generally most serviceable. A drachm of the tincture of can- 
tharides, rubbed up with an ounce of lard, will form a suffi- 
ciently stimulating ointment. The infusion of the leaves of 
the Asarum Europceum, a plant which occurs wild in the 
woods in England, is a very efficacious stimulant to the hair 
follicles ; the infusion may be used as a lotion to the scalp. 
Falling off of the hair, which is occasioned by eruptive dis- 
ease, or which is accompanied with inflammation of the skin, 
of course requires a different and more soothing treatment. 
, In the baldness of narly life, the hair drops off without the 
previous change of cJor which occurs iri age; in the latter 
case, of course, no treatment is either likely to be resorted to 
or to be of service. Still everybody must try, so let then 

SCROFULA, OB KING'S EVIL. 

The children most commonly attacked with scrofulous dii« 
eases, are those of a soft fine skin, fair hair, and delicatt 
complexion ; but it is sometimes seen in those of a more robuM 
make and darker complexion. Children having a tendency 
to rickets, as indicated by a large belly, large joints, and pro- 
minent forehead, very generally possess the scrofulous habik 
Those who reside in damp, uncomfortable dwellings, exposed 
to many privations, who are badly clothed, who live on scanty 
and unwholesome food, deprived of exercise in the open air, 



4:66 Scrofula. 

and who are inattentive to cleanliness, are those who are most 
subject to the disease. The countries where scrofula is most 
prevalent, are those of a cool, moist atmosphere, where the 
seasons are variable, and the weather unsteady. Seasons and 
weather, which remain cold and wet for a considerable time, 
aften prove the occasion for an attack of scrofula. 

This disease is hereditary from parent to child ; and families, 
the members of which have a tendency to scrofula, ought to 
be particularly careful as to the manner in which they bring 
up their children. Since the malady is not always in active 
operation, it becomes a matter of great importance to know 
whether it can be kept from appearing and committing its 
destructive ravages ; whether any management in early life, 
or in more advanced years, will protect the lively child or the 
beautiful youth from the dargerous enemy which has attacked 
his fellows, and whether an early and assiduous care may not 
counteract the hereditary constitution of scrofulous families. 

Children who show any predisposition to scrofula, should be 
brought up on plain, but nourishing and easily digestible 
food ; such as good broth, with a moderate allowance of solid 
meat ; but pastry, heavy puddings, and the like, should be 
avoided. Their clothing should be warm, and they should use 
much active exercise in the open air when the weather is tem- 
perate and dry ; they should use the sponge salt-bath, and, in 
the proper season, sea-bathing. 

The disease most commonly first shows itself between the third 
and seventh year of a child's age ; but it may arise at any 
period before the age of puberty, (about twelve years of age,) 
after which it rarely makes its first appearance, at least 
ixtemally. 

The attacks of scrofula usually begin some time in winter or 
spring, and get better or disappear in summer or autumn. 
The first appearance of the disease is the occurrence of small 
round tumors under the skin of the neck, about the ear, or 
below the chin, without any pain or discoloring. In some 
cases, the joints of the elbow or ankle are the parts first affect- 
ed. In this case, the swelling surrounds the whole joint, and 
impedes its motion. After some time, the tumors acquire a 
larger size, the skin which covers them becomes more purple 
and they inflame, come to a head, and break into little holes, 
from which a mixed pus-like fluid, intermixed with curdy* 
looking matter, at first proceeds, which soon changes into a 
thin watery discharge. These ulcers spread unequally in va- 
rious directions ; some of them heal, but other tumors form, 
followed by other ulcers. In this way, the disease contiuue* 






Scrqfida 467 

a number of years, and at last the ulcers heal up, leaving 
behind them very disagreeable scars, which are often the causa 
of great deformity. In some scrofulous habits, the eyes and 
eye-lids are the principal seat of the disease, shown by the in- 
cessant inflammation of the ball, and the raw and painful state 
of the lids of the eyes. Diseased spine is also much connected 
with a scrofulous constitution. Many internal parts are sub- 
ject to disease in scrofulous habits. The mesenteric glands, 
(situated along the inside of the back-bone) through which the 
fluid destined for the nourishment of the body has to pass, 
become obstructed, inflamed, or break ; the consequence of 
which is, a swelling of the belly, while the rest of the body ig 
wasting ; hectic fever, disordered bowels, and gradual decay. 
The lungs of scrofulous persons have, almost universally, tu- 
bercles or little whitish knots in them, which inflame and breah, 
and are the commencement of fatal consumption. Water ii 
the head, which carries off so many children of the same fam- 
ily, is believed to be connected, very generally, with scrofi > 
lous taint. 

It is certainly proper, as far as we can, to prevent the tumor i 
from coming to a suppuration or head ; and for this purpos< », 
we are to endeavor to promote their dispersion by the prudei t 
use of gentle friction with any mild liniment, or the dry hand, 
aided by proper diet, with occasional purgatives ; taking cai 9 
to avoid all exposure to cold and moisture, and to keep tie 
swelled parts covered with flannel. Flannel should be worn 
for under-clothing at all seasons of the year. When we find our 
attempts to promote a resolution (or scattering) of the tumors to 
be unavailing, we must apply to them flaxseed poultices ; and 
at the same time give nourishing diet to invigorate the system, 
and bring it to a head. It becomes a matter of importance 
how to treat the abscesses when matter is formed ; whether to 
let them break, or to open them with the lancet. Whichever 
way they are opened, there is a probability of a long-con- 
tinued discharge ; but by allowing the matter to be discharged 
by a lancet, a small and effectual opening can be made; 
whereas the matter, if the swelling be left to itself will per- 
haps break, and discharge at several different places ; ani 
nothing will be gained, with respect to the continuance of the 
after-discharge, or the prevention of unseemly scars. When the 
ulcers remain open and spread, a variety of applications will 
be necessary. Sometimes a stimulant dressing is required, as 
the ointment of verdigris, (ten grains to the tablespoonful of 
ard,) or basilicon ointment ; at other times, simple dressing, 
jb lard, or cerate, is all that can be borne. Sometimes a de» 



468 Abscess. 

rrec of inflammation will suggest the propriety of a poultice , 
but this must not be continued long, lest we induce a relaxa- 
tion of the parts around. We must vary our treatment also, 
by the application of different washes, astringent or cooling, 
as sulphate of zinc, (one teaspoonful to a pint of water), or 
sugar of lead, in the same proportions. Under every treat* 
ment, scrofulous ulcers are apt to disappoint our hopes, and 
continue open for a tedious time ; and at length, in many 
cases, without any perceptible cause, they suddenly put on a 
healthy action, and heal up, not to break out any more. 

The constitutional treatment, during this period, should be 
as invigorating and as little stimulating as possible; a good, 
wholesome, but light diet, pure air, and active exercise are 
necessary ; a residence in the country, and sea-bathing are 
iseful auxiliaries. 

Iodine in its various preparations, (see list of " Medicines, 
their doses and uses,") especially that of the iodide of iron y 
ulso iron itself, with tonics generally, and, above all, the use 
of codliver oil, are the principal remedies. From five to tea 
drops of tincture of iodine, mixed with a tablespoonful or two 
of codliver oil, three times a day, is about the best prepara- 
tion, given in syrup. In some countries there is considerable 
Importance attached to the contagiousness of scrofula. It 
cannot be considered contagious in the ordinary acceptation 
of the word, but it must be always advisable, especially for 
those predisposed to the disease, to avoid close contact with 
the affected. 

Hay- Asthma, or Summer Bronchitis— Hay-Fe 
v<5i*. — This disease is so called on account of its occurring 
during hay -time, or summer, and is thought to be caused by 
the odor of new-mown hay ; but it may be caused by other 
strong odors. It does not differ very much from the ordinary 
asthma, except perhaps there is not so much difficulty of 
oreathing, and the attacks last longer in the hay-asthma ; the 
Ining membrane of the nose is also much more inflamed and 
the throat irritated in the latter disease. 

The best thing to do is to remain within doors and keep 
quiet for a few days ; take a few doses of Rochelle salts or 
rhubarb, also a teaspoonful of paregoric at bed-time for two 
or three nights, and live on light diet. A dose or two ot 
quinine (one grair v may be beneficial, night and morning. 



Stricture of the Urethra or Urinal Passage. 469 

Stricture of the tJretttra or Urinal Passage— 

Jonsists in chronic inflammation, usually following gonorr- 
hoea and gleet, causing a narrowing of the passage, and thereby 
interfering with the voiding of the urine. The disease if 
caused also by masturbation, and anything that produces a 
chronic irritation in the passage. The diseased condition exist* 
during the early or first stage of stricture, only as a soft, 
iwollen or puffy state of the delicate skin lining the passage 
in the next or second stage of stricture, an important chang* 
has taken place. That portion of the passage which waa 
before in a merely tumefied or swollen condition, has noT 
acquired a certain firmness ; it resembles a band encircling 
the passage, narrowing it at this point, and actually reducing 
ts capacity. It now oners a decided impediment to the urine, 
and if a moderate sized instrument (Bougie) is introduced, an 
evident resistance is met ; though with a gentle pressure it 
yields, and the instrument pretty easily passes on. 

In a still more advanced or third stage, the dilatable condi- 
tion has disappeared ; the stricture has become firm, or cal- 
lous, as it is commonly called ; the contraction is unyielding, 
and an instrument meets an abrupt positive resistance, the 
calibre of the passage being frequently so diminished ai 
hardly to allow the urine to pass at all, or even an instrument 
of the smallest possible size. 

There is no natural cure for Stricture. When it once begin*, 
it is sure to go on increasing, either rapidly or slowly. Fortu- 
nately, however, we have the means of curing it by art. 
Among the very early symptoms of a Stricture, theie is one 
in which great confidence may be placed. It relates to the 
manner in which the last few drops of urine pass, which is by 
dribbling away. This is a symptom of great value in deter- 
mining any doubtful case of Stricture. Another early symp- 
tom of stricture is a scattering of the stream of urine in 
making water, or splitting into two or three small streams. A 
certain hesitation in commencing to urinate, although the 
stream flows fully and easily enough when once started, may 
be added. It is very common to have this hesitating or wait- 
ing longer than natural, then a full stream, then again the 
dribbling away afterwards. 

The remedy for Stricture is Bougies ; they are to be intro- 
Juced up the urinary passage, commencing with a small one, 
and using a lar.ger one from time to time, until the Stricture 
ie dilated, and the passage becomes of its natural size again. 
This treatment should never be attempted by any but a med- 
ical man, as it is of too delicate a nature to be undertaken by 
any other. 



470 Atbwninarta. 

A ihuminaria, or Bright's Disease of the Kid. 
neys. — This disease is an affection of the Kidneys, and waa 
first described by Dr. Bright, of England. Its most distin- 
guishing symptom is the presence of the serum (or watery 
portion) of the blood in the urine, so that when the latter 
nuid is heated to near boiling, the albumen becomes coag- 
ulated, like the white of an egg^ causing merely a cloudi 
ness if in small proportion, but sometimes existing in such 
quantity as to form a nearly solid mass. This condition of 
the urine is always to be looked upon seriously. It some- 
times comes on slowly, more particularly in those addicted td 
the excessive use of ardent spirits ; or it may be the immedi- 
ate consequence of seveie cold and repressed perspiration; 
it is not an un frequent sequel to scarlet fever. The sudden 
development of this condition of urine is accompanied with 
feverish symptoms and dropsical swelling of the face, with 
Btiffness of the eyelids, swelling of the extremities, and if it 
proceed far, of the trunk of the body also. It ought at once 
to be submitted to the treatment of a physician. In the 
absence of this assistance, should sudden swelling, as above 
described, come on, and with it symptoms of general fever, 
a portion of the urine may be heated in a metal spoon to 
boiling ; if it becomes thick or cloudy, and if it is not cleared 
by the addition of a few drops of vinegar, it may safely be 
concluded that the kidneys are suffering. Blood, according 
to the strength of the patient, may be taken from the loina 
by cupping, the patient confined to bed, and a bath of the. 
temperature of 90° taken for half on hour, once in twenty 
four hours. A diaphoretic (or sweating) mixture, is to b 
given, and the bowels purged with cream tartar and jalap, 
*>r some other good purgative. The diet must be kept low 
48 long as fever continues. The case ought not to be trusted 
to domestic treatment further than is unavoidable • 

Poison- Vine Eruption. — -This Vine, a species of 
Sumach, and one or two other plants, cause by contact in 
some persons an inflamed eruption, or small blisters, which 
is in some cases very painful. Tiie hands and face are its 
most common localities, but it may appear on any other part 
©f the person. 

The treatment of this complaint is simple. Apply a mix- 
ture of one teaspoonful of sugar of lead, dissolved in half a 
pint of cold water, every two hours, with a camel's hail 
brush, or soft linen mop. Fluid extract of Virginia snake- 
root is said to be almost a specific, applied over the affected 
Earts freely and frequently* When nothing better can b* 
ad, *T>ply sweet oil or common laid. 



Advice to the Young of both Sexes, 471 

ADVICE TO THE YOUNG OF BOTH SEXES. 

THE PHYSIOLOGY AND PHILOSOPHY OP RIGHT LIVIVflh 

There is a right way of doing everything, in physical life 
as in the vegetable kingdom, the selection of proper Seed and 
Soil is indispensable to the production of a perfect plant, so 
in the animal is the enlightened and judicious blending of 
the sexes a sine qua non to the production of a being repre- 
senting all the excellence of its species. This is an axiom the 
most unassailable; and hence the vital necessity of accepting 
it in all its integrity, and of never transgressing it in any re- 
spect upon the exalted plane of human existence. 

The sentiment of love, in its highest and most divine accep- 
tation, can obtain between the sexes only. Although far from 
antagonistic to that of friendship or affection, it differs widely 
from it; inasmuch as it has more important ends to attain, 
and can never exist between individuals of the same sex. 
Friendship or affection for one another, may characterize the 
intercourse of men, or of women ; but love, in its truest sense, 
never. This latter is the golden link which unites us at once 
to our opposites and to heaven, and that culminates in that 
holy and mysterious compact which results in the propagation 
of our species, and the accomplishment of our mission in this 
direction. 

While in pursuit of the study of this question, however, we 
must be careful not to confound or confuse the love under con- 
sideration, with the mere animal passion that so often steals 
its guise to gratify the cravings of lust, and that so constantly 
betrays the youth of both sexes into excesses that terminate, 
on one side at least, in years of misery or shame. And here 
we would address ourselves more especially to the inexperi- 
enced maiden whose guileless heart is too often open to the 
deceitful blandishments of some cruel suitor, who has but one 
object to attain, or to the sincere and ardent professions of 
some thoughtless youth, who, without pausing to analyze the 
motives which actuate him or the stability of his intentions, 
accomplishes her ruin, and leaves her to learn, alas ! too late, 
that, save before the altar, no woman is justifiable in placing 
her character and happiness in the keeping of any man. In 
such instances, deceit and sincerity being alike at fault, the 
only 6afe course for the maiden who would escape the Scylla 
of trie one or the Charybdis of the other, is to keep watch and 
ward on the battlements of her prudence and virtue, and, no 
matter how impassioned and sincere the pleadings of any iiv- 



4:72 Advice to the Young of loth Sexes. 

dividual upon whom she may have bestowed her affectiong, 
preserve both intact, as the only means of retaining his love 
and respect, should he be a true man, and of keeping herself 
unsullied in the eyes of society, and of the world generally. 

Although delicate and difficult the task of whispering 
some truths into the ears of a young maiden arrived at the 
years of discretion, yet, so necessary to her well being and 
happiness in every possible relation is it that she should be 
made thoroughly aware of the untoward influences which so 
constantly obtrude themselves into even the purest atmos- 
phere, we venture, although with some hesitancy, to assume 
the serious undertaking. And here we may observe, in the 
first place, that the primary elements of all that makes life 
worth a single hour's purchase, are to be found in a thorough 
recognition of what we owe to the Creator, to ourselves, and 
to society ; and the possession of a mind free from the taint 
which disfigures some of the literature of the day, and from 
those low desires and loose ideas, which, with scarce a single 
exception, result from its perusal. Nothing can be more dan- 
gerous to the youthful mind than even a passing glance at the 
works of any of those authors who appeal to the animal pas- 
sions in a manner so insidious and ruinous, and who, before 
a young maiden is aware of it, destroy all her sense of deli- 
cacy, and often, alas ! betray her into those dreadful excesses 
which, although kept the profoundest secret from every living 
soul save herself, invariably end in the total loss of innocent 
purity and the utter destruction of all physical beauty. We 
need not be more explicit upon this subject, but may summon 
on the witness-stand in proof of what we here state, the sallow 
and lifeless features, the dim eyes, and desponding gait, which 
are significant to the astute medical man, and which are to be 
encountered so frequently in what is termed the very best so- 
ciety. Any violation of the laws of the Creator in this, as in 
every other connection, is sure to be visited upon the aggres- 
sor; and when we come to consider that the first offence in 
the particular relation now alluded to, leads quickly to anoth- 
er, and yet another, until transgressions crowd upon each 
other thick and fast, and seize upon the whole being, we shall 
be able to perceive at once how vital the necessity for every 
young maiden to eschew with prayerful diligence the source 
of such terrible dangers, and to be in a position to feel within 
herself at the period when she may be called upon to give 
her hand at the altar to some one worthy all the love and af- 
fection that could be bestowed upon him, that she enters the 
marriage state aa pure in mind and body as the veriest child, 



Advice to the Young of both /Sexes. 473 

and that in this relation, not a cloud or a regret can obscure 
the sunshine of her after years. 

In the observance of the coarse which is here suggested or 
implied, lies the corner-stone of all the bliss that attends upon 
the sacred compact into which two young souls enter for life. 
And here we would observe, that, in this direction, a serious 
and solemn duty devolves upon mothers, to instruct at the 
proper moment, their daughters, as to the dangers that beset 
them, both mentally and physically, at a certain age. In 
this relation there should be no false delicacy felt. The truth 
must be told, and in a manner the most unmistakable. A life 
of happiness or of misery hangs on the issue, and there should 
therefore be no. mincing of the matter. The crime of self- 
abuse, if we must say it, is not confined to the sterner sex only. 
Some of the most fearful examples of it amongst females are 
to be met with terrible frequency, and of a character so hope- 
less as to embarrass all medical interference, and to seal the 
doom of those who had so fallen from their natural birthright 
and high estate. 

The necessity, then, of the strictest caution on the part of 
mothers in the selection of books or playmates for their chil- 
dren becomes obvious at a glance. The child is the marble 
from which the woman is sculptured ; and if the youthful 
block is disfigured, fractured or broken, where may we find 
the moral, mental or physical chisel that shall obliterate or 
remove the defects ? 

An eminent physician has justly observed on this head : — 

" We now approach a part of our subject which we would 
gladly omit, did not constant experience admonish us of our 
duty to speak of it in no uncertain tone. We refer to the dis- 
astrous consequences on soul and body to which young girls 
expose themselves, by exciting and indulging the morbid 
passion. 

"The results of the constant nervous excitement which this 
habit produces are bodily weakness, loss of memory, low spi- 
rits, distressing nervousness, a capricious appetite, dislike of 
company and of study, and, finally, paralysis, imbecility, or 
insanity. Let it not be supposed that there are many who 
suffer thus severely ; but, on the other hand, let it be clearly 
understood that any indulgence whatever in these evil courses, 
is attended with bad effects, especially because they create 
impure desires and thoughts, which will prepare the girl to 
be a willing victim to the arts of profligacy. There is no more 
solemn duty resting on those who have the charge of young 
females than to protect them against this vice. 



±74 Advice to the Toting of both /Sexes. 

"But, it is exclaimed, is it not dangerous to tell them any- 
thing about it ? Such a course is unnecessary. Teach them 
that any indecent language, any impure thought, is degrading 
and hurtful. See that the servants, nurses and companions 
with whom they associate, are not debased ; and recommend 
scrupulous cleanliness. 

"If the habit is discovered, do not scold or whip the child. 
It is often a result of disease, and induced by a disagreeble 
itching. Sometimes this is connected with a disorder of the 
womb, and very frequently with worms in the bowels. Let 
the case be submitted to a judicious, skillful medical adviser, 
and the girl will yet be saved. But do not shut your eyes, 
and refuse to see this fact when it exists." 

We have it on high authority that modesty is the chief 
quality in the adornment of woman ; and in no case is it more 
grateful and becoming than on that of a young maiden who 
has arrived at that important and interesting period when she 
may be wooed, and won, and made a wife. What the age of 
puberty is, has been made a careful study by medical men. 
In the temperate zone, fourteen years and six months is the 
average period of its first appearance in healthy girls. If it 
occurs six months earlier or later, then there is probably some- 
thing wrong. There is sometimes a wider deviation from the 
age stated here than this, and without any serious meaning; 
but at no time is such a deviation to be neglected. In a vast 
majority of cases it is owing to some defect in constitution, 
health or formation, and should be seen to and corrected at 
once, otherwise years of hopeless misery may be the result. " 
"Mothers, teachers," observes the author just quoted, "it is 
with you this responsibility rests. The thousands of miserable 
wives who owe their wretchedness to the absence of proper 
attention at the turning point of their lives, warn you how 
serious is the responsibility." 

The foundation of old age, observes a celebrated author, is 
laid in childhood, but the health of middle life depends upon 
puberty. This maxim is invaluable. The two years which 
change the girl into the woman, frequently seal forever her 
happiness or misery in this life. They decide whether she 
is to become a healthy, cheerful wife and mother, or the re- 
verse — to whom " marriage is a cwrse, children an affliction, 
and life a burden." 

It is not a favorable symptom to experience any indication of 
puberty before the usual average time, as it betokens a weak- 
ly and excitable frame. Let us therefore enumerate the prin- 
ciple causes which incline to hasten it unduly. Idleness of 



Advice to the Young of both Sexes, 476 

body, highly-seasoned food, stimulants, such as beer, wine, 
liquors; and in some degree, coffee, tea and irregular habits 
of sleep. The mental causes are, however, still more potent 
in tending to premature development. What stimulates the 
emotions, leads to unnaturally early sexual life. Late hours, 
children's parties, sensational novels, questionable pictorial 
illustrations, love stories, the drama, the ball-room, talks of 
love and marriage, &c, all hasten the event which transforms 
the girl into a woman. 

During the two short years, then, that .transform " the awk- 
ward and angular girl of fourteen " into the graceful maiden 
of " sweet sixteen," the utmost caution is to be observed in 
every relation, moral and physical. The magic wand of the 
fairy is at work, and a new creature, as it were, is being re- 
leased from her chrysalis state, with sentiments and responsi- 
bilities that must be kept well in hand. The transformation 
goes on until at last the system acquires the requisite strength, 
and furnishes itself with reserved forces, when the monthly 
periods commence. 

A writer of great judgment and experience on this subject, 
asserts that one of the most frequent causes of disease about 
the age of puberty, is starvation. He avers that many a girl 
is starved to death, from the fact of food of an improper qual- 
ity being given to her, or from the circumstance of sustenance 
being administered to her in insufficient quantities, or at im- 
proper hours. Hence, from the want of proper nourishment, 
the system becomes enfeebled and subject to attacks of disease, 
and especially to those of consumption. The food at such pe- 
riods should be abundant, varied, and simply prepared. Good 
fresh milk should be used daily, while tea and coffee should 
be thrown aside totally. Fat meats and vegetable oils, so gen- 
erally disliked by girls at this age, are exactly what they re- 
quire at this juncture of their lives. 

All kinds of exercise proper to a young lady, and especially 
those which lead into the pure open air and sunshine, are also 
beneficial at this momentous crisis ; and a particular kind is 
to be recommended for those whose chests are narrow, whose 
shoulders stoop, and who have a hereditary predisposition to 
consumption. Let her stand erect, throw the shoulders well 
back, and the hands behind ; then let her slowly inhale pure 
air to the full capacity of the lungs, and retain it a few seconds 
by an increased effort; then it may be slowly exhaled. After 
one or two natural inspirations, let her repeat the act, and so 
on for ten or fifteen minutes, twice daily. 

At first the monthly loss of blood exhausts the system. 



4:76 Admce to the Young of both Sexes; 

Therefore, plenty of food, plenty of rest, plenty of sleep, are 
required. That ancient prejudice in favor of early rising 
should be discarded now, and the girl should retire early, and, 
if she will, sleep late. Hard study, care, or anxiety, should 
be spared her. 

With thoroughly healthy girls, what is usually termed the 
monthly period, continues to recur at regular intervals, from 
twenty-five to thirty days apart. This is true of something 
like three out of every four. In others, a long interval, occa- 
sionally six months, occurs between the first and second sick- 
ness. This latter, if the general health is perfect, need excite 
no apprehension ; but under the slightest mental or physical 
derangement the case must at once receive intelligent treat- 
ment. Perfectly healthy young women have, on the other 
hand, been known to have been unwell every sixteen days, 
while others again experienced this change every thirty-five 
or thirty-six days only. 

At this critical period, the seeds of hereditary and constitu- 
tional diseases manifest themselves. They draw fresh malig- 
nancy from the new activity of the system. The first 
symptoms of tubercular consumption, of scrofula, of obstinate 
and disfiguring skin diseases, of hereditary insanity, of conge- 
nital epilepsy, of a hundred terrible maladies, which from birth 
have lurked in the child, biding the opportunity of attack, 
suddenly spring from their lairs, and hurry her to the grave 
or mad-house. If we ask why so many fair girls of eighteen or 
twenty are followed by weeping friends to an early tomb, 
the answer is, chiefly from diseases which have their origin at 
the period of puberty. 

From what has been now said it is impossible for any mother 
of ordinary good understanding to mistake for a moment the 
shoals and quicksands, both moral and physical, that surround 
her daughters, whether as mere girls, or grown-up maidens. 
A careful supervision of the company they keep and the books 
they read —their determined exclusion from the society of 
'either men or women of lax conversation or morals, and the 
careful inculcation of self-respect, which can alone be based 
upon proper pride and purity, will go far to obviate the dan- 
gers that beset their path, and so ground them, ultimately, 
in the principles of virtue and a correct demeanor, as to put 
evil thoughts to flight on their first approach. 

While a handsome person and excellent acquirements are 
always desirable on the part of any individual who pays his 
addresses to a young maiden, yet there are other and more im- 
portant considerations which ought to overshadow mere physi- 



Advice to the Young of both Sexes, 477 

cal beauty or mental attainments ; and these are a high sense 
of honor, and a thorough and practical conception of the duty 
we owe to God and man. These latter constitute the imper- 
ishable part of our nature when properly moulded, and are 
the staff upon which we can lean with confidence when our 
mere physical being loses all its brightness, and totters to its 
fall. Hence the necessity of warning the young and untutored 
heart against mere outward appearance, and directing it to- 
wards a recognition of those attributes and features on the part 
of the sterner sex, upon which a life of true happiness can alone 
be founded. 

This is a matter of such paramount importance, that we feel 
the necessity of impressing it, to the utmost of our ability, up- 
on those who have arrived at the years of understanding, and 
whose hearts may yet be free or partially so ; and who may be 
induced to pause ere they commit their happiness for life to 
the hands of those who may not only be unworthy of a wo- 
man's love, but who seek to obtain it under the false pretences 
of a comely exterior or the adventitious matter ot dress, while 
every fibre of their nature may be selfish beyond measure, and 
set only upon the momentary gratification of a passion that 
when once satisfied turns aside from the hapless and unsus- 
pecting object that has inspired it, and leaves her to mourn in 
the silence of her lonely chamber, the fate she might have 
avoided, but that is now beyond repair. 

How warm soever her feelings and sentiments, every step 
taken in the paths of courtship by a marriageable maiden 
should be well observed and guarded. In her conversation or 
conduct there should be nothing of thoughtless levity, or any- 
thing that could warrant a familiarity on the part of her suitor 
which might not be taken in the presence of some dear friend 
or relative. To observe a proper and well-considered course 
in this relation, is to secure the increasing admiration of the 
being upon whom she has bestowed her affections, if he be 
worthy her love. 

There is, therefore, nothing so desirable as firmness and cau- 
tion on the part of a young maiden in her conduct towards her 
accepted lover ; and both can be observed without wounding 
his susceptibility, or impressing him with the idea of either 
prudery or coldness on her part. 

Let us glance for a moment at the fact of so many beauti- 
ful and warm hearted maidens whose happiness has been 
wrecked, even in this city, through the fiendish machinations 
of perfidious suitors. Scarce a house of ill-fame in our midst 
but has one or more inmates of this character — poor, thought- 



4:78 Advice to the Young of loth Sexes, 

less, and confiding creatures, that would sooner had thought 
an angel of light capable of deceit than those who had be- 
trayed and ruined them. But they would not be warned, or 
had not been advised until the die was cast. 

Although the mental and physical tendencies of mere girls 
may vary in no small degree, we are of the firm belief, that, 
under even the most unfavorable circumstances, both may, 
through judicious and proper treatment, be brought to har- 
monize with the great objects of creation. In view of the ac- 
complishment of this vast desideratum, then, the early 
inculcation of proper religious principles, and the ensample 
of healthy conversation and moral excellence in the family 
circle, are of paramount importance. And this is quite com- 
patible with the freedom necessary to the happiness and 
well-being of even the lightest heart and most joyous disposi- 
tion. There is not an innocent amusement or pleasure 
incident to the life of a young girl, that may not be height- 
ened and sanctified, in a measure, through the adroit and 
loving guidance of a mother of sound observation and an or- 
dinarily well-trained mind. Mothers and guardians should 
therefore bestir themselves, if they would do a noble and 
abiding work in this connection ; and never relax their vigi- 
lance until those under their charge have attained the age of 
maturity and understanding, in the fullest- sense. Here the 
parent plays a most important part, and must, if she would 
see her daughter a happy wife and mother, train her in all 
the paths of virtue and correct thought. The surveillance 
may be gentle and loving, but it must, at the same time, be 
constant and inflexible. Every rock and shoal must be point- 
ed out, and dwelt upon with force and clearness, and the 
guiding lights of self-respect, purity of speech, and careful 
demeanor, held constantly aloft and in full view. Conse- 
quently both mother and daughter should understand each 
other upon an issue so vital ; the younger and more inexperi- 
enced looking, with full confidence, for counsel and advice 
to her truest friend and rightful preceptor, and forming no 
acquaintance or friendship, with a view to matrimony, without 
her sanction and approval. 

In this relation the quick wit and keen eye of the sober and 
thoughtful matron will be seldom at fault. She will be able 
to determine with something like unerring accuracy, and 
speedily, the character of the suitor who may seek to win the 
affections of her child, and who must not be judged on mere 
external appearance, or be taken at his own estimate. Here 
an honest heart, industrious habits, and a good record, are of 



Advice to the Young of both Sexes, 479 

the last importance, and more desirable than gold itself. In 
saying so much on this head, however, it is not to be supposed 
that mere worldly wealth is to be disregarded as an element 
in any compact between two hearts that would become one, 
and spend together a life of usefulness and independence. 

The vital necessity, then, of worthy male companionship, in 
the first instance, for any young girl whatever, must be ob- 
vious to even the most commonplace intelligence. If those 
who surround her are pure and good, and the uncompromising 
enemies of the free-love taint and principles which are now so 
ripe in certain quarters, her selection of a proper companion 
for life will be the less difficult, as fewer chances present them- 
selves for bestowing her affections unworthily. 

Let us then hope that all those most deeply concerned will 
ponder well the facts we have laid before them on this all-im- 
portant subject, and let no mother relax for a single moment 
the vigilance that should wall out from her daughters the 
dangerous books and companionship to which we have made 
such distinct reference. In addition, let every young maiden 
who is approaching the interesting and critical period already 
named, look well to her footsteps, and beware of allowing 
her affections to be captured hj a pleasing exterior only on 
the part of one of the opposite sex. However agreeable an 
attractive face and form, these do not comprise all that is ne- 
cessary to the most abiding and exalted manhood, and are not 
unfrequently a delusion and a snare. There is no absolute 
manliness without manly principles ; and no true happiness 
without moral rectitude and a proper sense of our duty to- 
wards heaven. These are the attributes and sentiments that 
tend to make earth a paradise, and that survive all mere phy- 
sical excellence, inasmuch as they belong to our immortal 
part. Let them therefore be sought after assiduously by both 
mother and daughter in the person of any. suitor for the hand 
of the latter ; and let there be no uncertain sound in the 
premises. 

The license accorded to boys when compared with that allow- 
ed to girls of the same age, ought to engender in them a 
chivalrous respect for the gentler sex, and never urge them 
into anything savoring of egotism or tyranny. The apparent 
superiority is but simply the result of greater physical strength, 
and the freedom with which the one sex is permitted to move 
through the world compared with that accorded to the other. 
There is in reality no mental superiority in the one over the 
other; for in this respect it has been shown that the impress of 
man has not been left mentally on the age more than that of 



480 Advice to the Young of both Sexes. 

woman ; because, from some ill-j udged laws or rules of society, 
she has been subject to restrictions which circumscribes to an 
unwarrantable extent her sphere of action. 

But while laying it down as an axiom that there is perfect 
mental equality between the sexes, we cannot refuse to enter* 
tain the idea that woman is the weaker vessel physically, and 
that her dependence upon man, and her claims to his love and 
protection, arise to some extent from this cause, although the 
sublime mystery of her being appeals to him in a higher and 
more abiding sense. 

Although, as already observed, a greater latitude is allowed 
to boys than to girls, in almost every relation, yet this latitude 
must be circumscribed and confined to certain well-defined, 
healthy bounds. And here we would again dwell upon the 
vital necessity of good companionship and good books, where 
example and precept harmonize with the exalted ends to be 
attained in after years. Of course, the family circle is to be 
regarded as the true starting point, whence the earliest lessons 
in vice or virtue are derived, and should this prove to be lax 
in any of its teachings, moral or religious, the very germs of 
success are embarrassed or destroyed at once. 

It is astonishing how quickly young lads, not much more 
than half way to their teens, acquire bad habits and principles 
from impure associates, or the unguarded conversations which 
sometimes occur at their own fireside. From both these 
sources the worst consequences are to be apprehended, as they 
gradually undermine every principle of good, and so familiar- 
ize the tender ear and understanding with what is most per- 
nicious, because of the almost indelible and fatal impress that 
is left upon the unreasoning susceptibilities. Whatever 
may be said to the contrary, there are unmistakable traces of 
the early hearthstone to be found in the lives of most men; 
and such being the case, how indispensable it is that the 
atmosphere that surrounds it should be free from taint, and 
that the greatest caution should be observed that nothing 
transpires within its sacred limits that might have the slight- 
est tendency to mar the man in the child, or thwart the be- 
neficent designs of nature regarding him. 

In view, then of the influence of the family circle, and 
that of the father upon the son, while yet a mere youth or 
child, that circle should be made as attractive as possible, 
and on a plane thoroughly comprehensible to the intelligence 
to which it appeals. Li parents would shape their children 
to the noblest ends, they must gain their confidence and 
affection by becoming children themselves in a measure. 



Advice to the Young of loth Sexe$ % 481 

Hiey cannot preach or teach to any purpose from a reserved 
or exalted pedestal, or through the instrumentality of the 
sober long-faced truths which are applicable to grave years 
only. The atmosphere of youth is, in the natural order of 
things, bright and happy ; and if we would influence, by 
precept or example, those still surrounded by it, we must 
assume to breathe it ourselves for the time being, and sow 
our earliest good seeds in its tender light. Once the kind 
and judicious father has won the heart and confidence of his 
little son, the road to the fullest success lies wide open ; and 
feet that under other circumstances would assuredly have 
turned aside under less benign influences from the paths 
of rectitude and truth, are now easily directed into that 
glorious upward and onward course which never fails to cul- 
minate in happiness here and hereafter. 

Some of the most terrible evils which beset the path of so 
many of the young of the sterner sex, result from association 
with children of their age who have learned to debauch 
their own persons, and to indulge in those secret habits which 
have been long noted as fraught with disaster and death. 
So early the period at which unsuspecting little ones are led 
into this terrible snare by their seniors of two or three years, 
that few will be inclined to believe that this first essay in 
crime has been attempted at the age of eight, and continued 
until an actual drain on the young energies and vital forces 
of the system commenced. Let the playmates, the toys, 
and the rudimentary books of the child be carefully selected, 
and let there be for him an abiding attraction about his own 
door and fireside, so that he may not be necessitated to look 
abroad for any of those innocent pastimes or recreations that 
have such charms for the young. The great error of many pa- 
rents, in this direction, lies in the dry and solemn homilies 
which they conceive ought to be forever mumbled into the 
ears of their children, or the long religious services to which 
they regard their subjection as wise and indespensable. This 
is a fatal mistake. The medium through which the young 
are to be taught successfully their dependence upon heaven 
and their duty towards God and man, should rather consist 
of the green fields, fruits and flowers — of sunlit skies, run- 
ning brooks and balmy winds — the songs of birds, the 
changing seasons, and the summer woods. These and the 
beneficent design of the Creator in calling them into exist- 
ence for the benefit of man in a pre-eminent degree, should 
form the earliest pages presented for the study of the child ; 
and if each of the beauties aud truths thev contain be care- 



482 Advice to the Young of both Sexes. 

fully explained upon the basis of that higher information 
which may be sought through the " revealed word ,5 as the 
young student advances in years, the result will be the most 
nappy, and culminate in all the perfection possible of attain- 
ment in this earthly sphere. 

But while inculcating these salutary lessons, there must be 
no false delicacy on the part of the father relative to pointing 
out, in the clearest possible manner, the dangers with which 
his inexperienced and susceptible child is assuredly sur- 
rounded. The parent is but ill versed in his duty, or the 
prevalence of the crime of self-abuse in the young, who fan- 
cies that by keeping his youthful offspring in ignorance, so 
far as he knows, of the character and manner of this fright- 
ful offence, that the child must necessarily escape its taint. 
Let there be no misconception on this head ; for ic may be 
accepted as a leading fact, that nineteen boys out of every 
twenty learn something of it at a very tender age; and from 
sources, too, but badly qualified to warn them of its terrible 
results. 

To the youth of understanding, however, we may address 
ourselves more directly ; assuming that he may not be alto- 
gether free from the taint of this sin. In the first place, then, 
let us lay it down as an inexorable fact, that so terrific and 
contaminating is this practice in any degree, that it not 
only tends to destroy every particle of physical beauty and 
manhood, but," if persisted in, results in absolute idiocy, or a 
premature and most horrible death. This is no overdrawn 
picture, but may be taken as an absolute fact, in connection 
with the quite as inexorable truth that the youth addicted to 
this prevailing vice is as certain to render himself incapable of 
propagating his species or consummating the holy sacrament of 
matrimony, as that the sun is in the heavens at midday. 
There is no escape from the consequences of this monstrous 
offence, should it be indulged in to a certain point ; for then it 
seizes upon the whole being, and, like the infatuation of the 
arsenic eaters, whether continued or abandoned, ends alike in 
the most appalling mental or physical suicide. 

There may yet be time to retrace his steps, and escape the 
awful depths that yawn beneath him ; while the commission 
of a single offence more may hurl him irrevocably to his dread- 
ful doom. Oh ! could we but depict in adequate language the 
fearful and hideous wrecks that have resulted from this crying 
sin against nature ! 

And now that we have dwelt at some length on this part of 
our topic, let us turn for a moment to those youths w r ho have 



Advice to the Young of both Sexes, 483 

sufficient virtue, manliness and strength to eschew this great 
evil, and say to them that, although they have escaped it, 
their path is still beset with other snares which lead to discom- 
fort and misery in a lesser degree only. If not prostrated at 
this disgusting shrine, we have known the manhood of many 
to fall a victim to unholy and misguided passion, and who, by 
giving full rein to their unbridled lust, or falling into the 
snare of some casual circumstance, have brought woe to true 
and unsuspecting hearts that loved "not wisely but too well." 
And here we would observe, that when a respect and highest 
consideration for the opposite sex is not entertained by a man, 
whatever his condition, he is unworthy the recognition of 
society or the favor of heaven. There is something of infinite 
treachery and cowardice on the part of a suitor, sincere or pre- 
tended, who steals into the affections of a young maiden, with 
a view to betraying her, or who, having once gained them on 
an honorable basis, takes, in an unguarded moment, advantage 
of the love she bears him, to humiliate her in her own eyes, if 
not to accomplish her ruin beyond redemption. No true and 
chivalrous man or youth who respects the person or the memo- 
ry of the mother who bore him, has ever been guilty of doing 
such dastardly violence to the sex, or of treading ruthlessly 
beneath his feet what God has made so confiding and beautiful, 
and what is in every relation the counterpart of his own sister. 

To be succinct, then, when a youth finds himself approach- 
ing the threshold of manhood, or that period of life which 
succeeds his mere boyish days, he in most cases enters upon 
a new and charming phase of his existence, which is ex- 
pressed mainly in a desire for female society, and generally 
for that of one being beyond all others, who in his admiring 
eyes appears to be the best and most beautiful of her sex. 
Now this is nothing more nor less than the first dawning of 
love, and before we would have its partial victim commit 
himself irrevocably to the overpowering passion in any 
individual case, we would implore him to pause on the verge 
of the charmed circle, and ere he become hopelessly en- 
tangled in its delicious mazes, seek advice from his natural 
guardians, and analyze for himself all- the circumstances 
surrounding the being who has awakened such strange sen- 
sations in his bosom, and the possible result of attempting to 
unite his destiny to hers forever. 

To this end, he must endeavor to look upon things as they* 
really exist, and not permit his enthusiasm or admiration to 
present them in any romantic or fanciful light. As a primary 
step in this direction, he must measure his own pecuniary 



484 Advice to the Young of both Sexes, 

circumstances and prospects, and see how far justified lie 
might be in endeavoring to win the affections of any young 
maiden with a view to making her his wife. We are, of 
course, aware that but few inexperienced youths pause thus 
practically upon the threshold of new hopes and aspirations ; 
but then this does not nullify the wisdom and necessity of 
doing so. No honorable or prudent person will commit him- 
self to a step so serious as that of marriage, without seeing, 
to some extent, the road before him ; nor will he tamper with 
the love or affections of any woman whatever, whom he 
considers unworthy to become his partner for life. In the 
fullest manliness on this point there is a chivalry the most 
noble and exalted. Everything like deceit must be dis- 
carded totally, and if it is found that the over-sanguine 
fair one has misinterpreted any word or act of kindness on the 
part of him who may regard her as a friend only, she must 
be undeceived, and at once. 

After becoming satisfied that he is in a position to support 
a wife, and being free in person from such physical blem- 
ishes as have been already alluded to, the first care of the 
expectant bachelor should be to select from among his ac- 
quaintances a maiden of comely looks, industrious habits, 
and sound and pure morals. These are essentials the most 
important, and must underlie all the accomplishments which 
render a woman fascinating, if she is ever to become the 
light of her own household. There can, of course, be no 
objection to the possession of those ornamental acquirements 
which render a drawing-room so attractive at times, such as 
music, bright conversational powers, and all the agreeable 
phases of a polite education ; but these, desirable as they 
undoubtedly are, must not be accepted as the true consti- 
tuents of happiness ; but rather as the agreeable guise that 
the more serious and abiding attributes assume, until the 
moment for their more active agency presents itself again. 

But, now presuming that our young suitor is fairly on the 
carpet, and that, with the sanction of his parents or guardian, 
which is indispensable, he has determined to win, if possible, 
the heart of some fair one supposed to be possessed of all the 
attributes, and the germs of all the qualifications adverted to, 
it must be apparent that his hour of danger and difficulty has 
arrived, and that in dealing with it, the greatest caution and 
prudence ought to be observed. With a view to the fullest 
success, then, and in furtherance of the great object UDon the 
holiest and highest basis, the moment he perceives a being 
worthy all his love and affection, she must at once become 



Advice to the Young of both Sexes. 485 

sacred in his eyes and never be the subject of any familiarity 
that might shock her ears or her sense of propriety in any de- 
gree, or that might tend to lower her in her own estimation. 
The more chaste and considerate his intercourse with her, to 
even the most trifling word or whisper, the higher her sense of 
his nobility, and consequently, the warmer and the more pro- 
found her sentiments of love towards him. One impure, in- 
delicate, or low word uttered in the ear of a truly chaste and 
virtuous woman may be destructive of her true happiness for 
all time to come ; while a single trifling act savoring of the 
libertine could not fail to estrange her from the transgressor 
forever, if faithful to her pride or sex, or else so humiliate her 
in her own eyes, as to cause her to feel that the love she 
brings to the altar is not so worthy, so fresh, or so sanctified, 
as it would have been had it not been soiled and dishonored, 
in a measure, by him who should have guarded it more 
jealously. 

And now that we have been so explicit on this point, we 
must go farther, and warn the ardent and well-meaning suitor 
of another precipice that besets his path from the period of his 
declaration to his appearance before the altar, and that is, the 
great danger that attends the warm embraces which a lover 
sometimes bestows upon his affianced, when alone, without 
presuming for an instant, that his passions may outstrip his 
reason, and, in a moment of intense excitement, hurry him 
into an excess that would destroy the purity and self-respect 
of the being who confided so implicitly in his honor, until she 
6tood before him a guilty and injured woman. This is a mat- 
ter for most serious consideration ; for notwithstanding that the 
aggressor makes every reparation in his power and still re- 
deems his plighted vows, the memory of this great indiscretion 
or crime is likely to overshadow all his subsequent married 
life. Let it then be distinctly understood, that even the or- 
dinary embrace so frequent between two young lovers before 
they become united in marriage, must be indulged in with 
caution and reserve, where no eye but that of heaven is upon 
them. 

But if we have dwelt upon w T hat may be termed the two 
leading evils which beset the path of youth, there are yet 
others, scarcely less dangerous, which require the most care- 
ful consideration ; and one of these is the sin of intemperance. 
We need not travel out of every day common record for evi- 
dence to establish the dread consequences of this dire infatuation 
and its general prevalence. Like most other criminal practices, 
it 6teals through the first stages of its progress by slow and 



486 Advice to the Young of both Sexes. 

imperceptible degrees; but at each unconscious step, so se- 
curely does it entangle its victim in its meshes, that not 
unfrequently he passes beyond the final point of redemption 
before he is thoroughly alive to his lost and hopeless state. 
And here, again, the influence and habits of the home circle 
become of the first importance. If unswerving temperance 
be the inexorable rule of the household — if the seductive cup, 
in even the most harmless aspect, be banished from it with 
firmness and persistency, there is every hope that the dan- 
gerous out-door influences which so throng the path of the 
inexperienced, may be met and neutralized. 

But if the household be tainted, to any extent, with the 
vice — if indulgent fathers and mothers will tempt their child- 
ren with an occasional sweet spoonful of the poison, they do 
neither more nor less than set fire to one end of a slow fuse 
which is almost sure to result, one day or other, in the most 
fearful destruction. 

But as we are speaking, as it were, to a youth of under- 
standing, we must appeal to his own manhood and sense of 
right. And here we would observe, that next to the appalling 
crime of self-abuse, that of habitual intemperance is most 
destructive of pure love, and of the physical capacity or power 
to realize from the chaste passion all that heaven designed it 
should accord. No woman of correct feeling or judgment has 
ever bestowed her heart upon an habitual toper, or enjoyed 
his society for a moment, not to speak of his maudlin embrace. 
This is true beyond question, and to an extent so dreadful, 
that no inconsiderable portion of the infidelity which a ne- 
glected and disgusted wife visits upon her husband to-day, 
may be traced simply to the vice of habitual drunkeness on 
his part. Wo matter how warm the affections of the maiden, 
or how sincere the love of the wife, this curse tramples out both 
alike ; and hence the necessity of the utmost vigilance on the 
part of any youth who would win and retain the heart of a 
pure and beautiful maiden, or preserve his health and man- 
hood intact until both, at a ripe old age, declined in the 
natural order of things. It may be laid down as an axiom, 
then, that no true love can exist between a good and pure 
woman and the man who renders his person disgusting to 
her, and who in a measure emasculates himself through the 
constant use of intoxicating liquors ; and when we come to 
dwell on the fact, that the prostration of his high mission and 
manhood arises from the indulgence of a loathsome vice, 
whose inception is to be traced to the first fatal and seductive 
glass that is thoughtlessly raised to his lips, surely the individu- 



Husband and Wife, 487 

al who is jet free from the taint of this curse, or the man who 
is its partial victim only, should, if these few lines happen to 
meet his eye, never approach — or dash from him forever — 
the cup that has been so fraught with some of the direst 
crimes, heartaches, and miseries, known to the human fam- 
ily. When, therefore, it is a fact beyond contradiction, that 
a persistent use of stimulants of any description tends to 
generate morbid and adventitious sexual desires, that are 
succeeded by a reaction the most depressing, inconvenient, and 
dangerous, and that frequently result in permanent injury, 
what shall we say in denunciation of the habitual use of those 
fiery potations that not only lead to rags and beggary, but 
corrupt the blood, disfigure the features, and trail the last 
particle of manhood in the dust ? 



HUSBAND AND WIFE. 

THEIR DUTIES AND RELATIONS TO EACH OTHER. 



A CHAPTER FOE THE NEWLY MARRIED, OR THOSE CONTEMPLATING 

MARRIAGE. 

It should not, then be forgotten by the newly fledged 
husband, that in the first moments of his matrimonial life, he 
must not suppose for a single instant the ears or the eyes of 
his wife are less chaste and pure than they were before she 
had become his in the sight of God and man. Here is a 
point of vital importance, and one upon which such grave 
issues hang that we place it in the very first rank of our 
present observations. Save in one instance alone, the conduct 
and consideration evinced towards the maiden must be mainly 
observed towards the wife ; for through this manifestation of 
respect and delicacy, the freshness and novelty of courtship 
may be continued for an indefinite period. Let the wife be 
preserved by the husband a beautiful mystery in part — let 
the natural veil of modesty which shrouds every pure woman 
be never ruthlessly torn apart, or her sense of propriety be 
blunted by coarse or indelicate remarks. As we have already 
descanted somewhat diffusely upon the rule of conduct to be 
observed on the part of the youth as well as on that of the 
maiden who intended to become one at the altar, so now that 



4:88 Husband and Wife, 

we presume them to be man and wife, we would bo equally 
explicit as to how they should comport themselves as such. 
In addition, then, to what we have already just said, we would 
observe that in the first moments of wedded life the constant 
and unreasoning abuse of the privileges of a husband can not 
but result in evil consequences to both parties, inasmuch as it 
tends to render commonplace that which is intended by an 
allwise Creator to be otherwise, and is the brightest and 
holiest link that unites the sexes. This privilege once famili- 
arized through constant and inordinate indulgence, loses all its 
charms, while the abuse which robs it of them, not only tends 
to injure the young wife physically, but the husband also. 
In this relation, the tide must flow and ebb according to the 
promptings of a law that none can fail to comprehend, and 
whose operations must not be accelerated if they are to be an 
unfailing source of delight, and to influence us through long 
years with undiminished powers. The reaction which inva- 
riably attends any coctinuous excesses of this character is so 
painful, humiliating and dangerous, as not unfrequently to 
lead to the most serious misunderstandings between the parties 
most concerned, and destroy that sweet confidence which 
should obtain between them. Again, the evil consequences 
of such excesses to the infant yet unborn are at times frightful 
to contemplate. A weakly and diseased frame, and, fre- 
quently, mind, are the dreadful results, while the health of 
the mother suffers commensurately. The young husband 
also pays his share of the penalty ; as the natural excitement 
which is the true key to all the pleasures that attend the sex- 
ual relations when indulged in upon the true basis, dies out 
under the enervating influences of satiety until the bond 
between man and wife becomes so relaxed in this relation as 
to be almost worthless. And let it be clearly comprehended 
here, that as this bond becomes weakened or vitiated between 
the young persons, so wanes their love and esteem for each 
other, until in time they come to look upon their union with 
apathy if not disfavor, and then are opened up all the ap- 
proaches to misery the most abject and heartrending. 

And if the most fitting place for the husband, after the 
labors of the day are over, is his own fireside, with his young 
wife by his side, she, " the partner of his joys and woes," must 
endeavor to surround his home with every possible attraction ; 
and light it up with a cheerful face and aU die nameless 
charms that make it " the only spot on eartli " to him. To 
this end, she must be always neat in her person, if at all 
within the range of possibility, for ther^ is nothing more 



Husband and Wife, 489 

pleasurable to a husband than a sense of the purity of the 
personal habits of his wife, and the comeliness of her attire 
when she presents herself before him. This latter involves 
neither labor nor very extraordinary expense. The bath, and, 
if needs be, the simplest fabrics, shaped, if necessary, beneath 
her own supple lingers, will meet all the necessities of the case. 
These are attractions of such virtue and potency that they 
always operate like a magnet, and not unirequently draw a 
husband away from the evil influences that tempt him to re- 
gard his home as a place of temporary sojourn only. We 
have paid some attention to the subject, and can vouch for 
the fact, that, in ninety -nine cases out of one hundred, a pure, 
industrious, and cheerful wife, who meets her husband with 
a bright and warm smile on the threshold of her dwelling, 
spends the majority of her evenings in his society, without a 
fear for the future. 

But there are other observances, also, which ought to be 
regarded with the most profound caution by the newly-mar- 
ried who desire to spend their days in comfort and happiness 
together ; and one is the maimer of their intercourse with such 
of the opposite sex as either the husband or wife may come 
into friendly contact with. Every properly constituted man 
or woman is more or less of a jealous disposition ; for without 
this sentiment, active or latent to some extent, there can be 
no true love. Censure it as you may — call it mean and petty, 
if you will — but the fact obtains, nevertheless. Who that is 
conversant with the press in any degree, but can bear evidence 
to the fact that scarcely a newspaper is published without 
some painful recital, bearing upon this point, meeting the eye. 
To avoid the devastating influences, or approach of the " green- 
eyed monster," should be a leading feature of the wife's pru- 
dence, as well as of that of the husband ; for so unreasoning 
and sensitive are our natures in this direction, that when they 
are once aroused to suspicion, they seldom or never recover 
their wonted tone of confidence. And yet the accused party 
may be virtually innocent of the crime laid to his or her 
charge, although there are generally some grounds for censure 
on the score of thoughtlessness or that lightness or trifling 
which is so liable to be misinterpreted by certain individuals. 
Above all things, then, and especially on the part of the wife, 
no matter what the purity of her soul or intentions, she is al- 
ways to be circumspect with regard to her conduct or inter- 
course, in company or otherwise, with any of the opposite sex. 
Caution and decorum in this connection is of the first 
importance ; for not only might any thoughtless familiarity, 



490 Husband and Wife. 

or any laxness of self-respect on this head be wholly misinter- 
preted by her husband, but, how innocent soever, be likely to 
fare no better at the hands of the individual towards whom 
she might have comported herself with unconscious levity. 
There is, therefore, nothing for it but the strictest prudence 
and an unswerving adherence to such a line of conduct as 
might be pursued with safety in the presence of her husband 
towards any gentleman of her acquaintance. Nor must there 
be any innocent secret confidences with any male friend, no 
matter how laudable the object, outside the sanction and re- 
cognition of her rightful counsellor and protector. The truer 
and prouder the husband, the more sensitive and jealous of 
his honor, and of his claims upon all the consideration to 
which he regards himself entitled on the part of the woman 
of his love — the wife of his bosom. 

As a general rule, then, no matter how intimate her gentle- 
men friends may be with her husband, or how frequently they 
may find a welcome beneath her roof, there must still be ob- 
served towards them that chaste and prudent course of conduct 
which they will not be slow to respect, or to attribute to the 
right cause, and which may be indulged in without the 
slightest shadow of acerbity or detriment to even the most 
generous hospitality. 

But it must not be presumed that the husband is not equally 
bound to be strictly observant on his part, also, as to how he 
comports himself in the opposite direction. The usages of 
society, we are well aware, allows him a greater latitude in 
this sphere than it accords to his wife; but then there are 
proper limits set to it likewise; and the moment he trans- 
gresses them he also becomes rightfully the subject of censure, 
and is an aggressor against the peace and happiness of the 
being he vowed to protect and cherish with all the love and 
affection of which he is capable. Yet, while the wife admits 
that civilized usages permit him to move with greater freedom 
among females than is accorded to her in her intercourse with 
males, she can determine, with the quick eye and intuition of 
her sex, when he transgresses the bounds of decorum, in her pre- 
sence, or fails in the allegiance due to her alone, and treasures 
the wrong within her soul of souls. In this it is impossible 
for a husband to deceive with continuous success the percep- 
tions and intuitions of the partner of his bed. There is about 
her that which fathoms and apprehends the most trifling 
approach to infidelity or immorality on the part of the man 
she loves. No matter how silent or uncomplaining she may 
appear to be, she feels, from certain unexplainable indioea 



Husband and Wife. 4&1 

perhaps, that all is not right ; and thus the canker sets in, that, 
if she loves with all her soul and might, gradually destroys 
all that makes life worth an hour's purchase, saps her life- 
blood, and hurries her to an early grave. 

These are truths which admit of no contradiction, and such 
being the case, the husband, in his turn, should, in his inter- 
course with the opposite sex, be just as careful and sparing 
of the feelings of his wife as she is of his. 

As in the unmarried state, so in the married, the selection 
of proper associates and friends is a matter of vital importance. 
No man or woman who is careless in this relation can fail to 
suffer from the circumstance. It therefore behooves the 
young husband to exclude from his house or fireside such per- 
sons of their acquaintance as are of loose or questionable 
habits, and who, beneath the mask of a pleasing exterior, 
conceal a heart given to deceit or lewdness. It is impossible 
not to suffer from frequent contact with such people ; and for 
a husband to introduce any of them into his household is to 
thrust an indignity upon his wife, and subject her to influences 
the most unholy. 

In the same way the wife must be cautious and circumspect 
in relation to the choice of lady friends and acquaintances ; and 
above all things, before taking them to her bosom, she must 
be thoroughly satisfied of their uprightness, and purity of 
thought and action. The very attire even must not be over- 
looked in the selection ; for where a young or an old woman 
is gaudily or expensively dressed, when there is not the am- 
plest means to sustain the folly, they are to be invariably 
regarded as undesirable companions — while, should they even 
be possessed of adequate wealth, they may be generally set 
down as light, frivolous people, of contracted minds and un- 
healthy tendencies. There is no difficulty at all in recognizing 
those upon whom the young wife may properly rely for 
womanly aid and sympathy, when such are necessary. The 
chaste matron, of silvery locks, with her sweet, pure daughter, 
who has been brought up to feel her dependence upon heaven 
and her duty towards the whole human family, are of the 
class whose society should be cherished and prized by the in- 
teresting creature who may soon become a mother. Those of 
erratic ideas and disquieting influences ought to be studiously 
avoided ; as their presence in any household is undesirable, 
from the fact that frequent contact with such persons often so 
blunt the sensibilities and confuse the sense of right and 
wrong, that domestic misunderstandings soon obtain, and the 
happiness that should attend a well-ordered family marred, 
perhaps, forever. 



^92 Husband and Wife. 

To succeed, then, in the marriage state, it may be laid down 
as a general rule, that the habits of both wife and husband 
shall be frugal, and their tastes congenial, to a great extent. 
If possessed of any antagonistic elements, their first and 
constant care should be to endeavor to harmonize them on 
the basis of love and chivalry — the husband yielding a point 
on the grounds of the one, and the wife moving forward a 
step to meet him under the promptings of the other. And to 
this end all disputations, how trifling soever, ought to be es- 
chewed with the greatest care. Out of mole-hills such as 
these, very frequently real mountains arise, and to the fatal 
disruption of all domestic ties. 

While making these observations, however, it must not be 
presumed that we ignore the culture of the mind or of the 
taste. On the contrary, the interests of both may be attended 
to with excellent results, if the manner of improving them be 
clearly understood. There is scarce an object in art or nature 
that does not afford a text to the sincere inquirer after truth ; 
"vdasall knowledge lies in understanding the one and the 
j 'ther in the profound est sense, this maybe approached, to 
some extent, by those in even the most restricted circumstan- 
ces, if they only begin at the right point and pursue their 
studies systematically. 

To the accomplishment of this end, all trashy novels and 
exciting romances should be scattered to the winds; and 
pleasant, instructive books adopted in their stead, whenever a 
moment can properly be devoted to reading. There is 
nothing which so unfits a maiden or a young wife for her 
duties as the study of such characters as are presented in the 
sensational yellow-covered literature of the day. 

These are considerations of the gravest importance. The 
young wife, to whom we now address ourselves more particu- 
larly, can not over-estimate their desirability. The moment 
she steps across her own threshold, she should, therefore, sur- 
vey all the circumstances of the case, and begin her wedded 
life on the only true basis, if a future of usefulness and 
happiness is her aim. Good habits, like evil ones, grow 
upon one; so that the first move beneath her own root should 
be taken with caution, and in the right direction. 

Another important desideratum relative to newly-married 
people is, the cultivation of each other's society when at all 
possible, and the constant study of each other's excellencies. 
These latter traits of character must be kept persistently in 
the foreground , and be made, so far as practicable, to cover 
whatever defects may, at times, peep out on the part of either 



Husband and Wife. 493 

the wife or the husband. To err is human, and we cannot, 
therefore, expect absolute perfection in ourselves or in others, 
so that by taking an occasional peep into our own hearts we 
shall be prepared, in a measure, to make allowances for 
whatever slight defects may be apparent in those who are 
near and dear to us. One of the strongest bonds of union 
between man and wife is that of mutual admiration of each 
other's society, a similarity of tastes and intellectual pursuits, 
and a desire to minister to each other's edification and 
amusement. No day or hour should pass without the aulti- 
vation of the warmest sentiments in this connection, for 
although the circumstances of business may separate the 
husband from the wife for many hours daily, yet the magnet- 
ism of true love and affection can go forth on its subtle 
mission, and apprise both that their hearts beat in union, and 
that they are looking forward alike to the happy evening 
hour which shall re-unite them. A cultivation of such 
thoughts and the indulgence of such sweet anticipations will 
tend to cheer both during their hours of separation, and give 
the keenest zest to the moment when they shall again meet 
in a fond and welcome embrace. Living in this happy rela- 
tion, life glides swiftly and sweetly away, in the bright 
anticipation of an eternal day of joy, that shall dawn upon 
us on the shores of immortality. 



494 "Valuable Receipts. 



These Recipes alone are worth more than the 

price we ask for the whole book. 

Vermifuge — To Destroy Worms. 

Spirits of Turpentine, one half an ounce, 

Oil of Wormseed, two drachms, 

Puiverized White Sugar, two drachms, 

Castor Oil, three ounces. 
Mix. An excellent remedy for worms. The dose for a child 
two years old is one teaspoonful; for one six years old, two tea- 
spoonfuls, and for older children in proportion. To be given night 
and morning upon an empty stomach for two or three days in suc- 
cession. If it should not move the bowels sufficiently, it may be 
followed by a dose of castor oil, or some other physic. The worms 
do not always come away, but are killed and digested. The phial 
should be well shaken before using the medicine. 



Compound Vegetable Tonic. 

Compound Tincture of Peruvian Bark, 1 

~ x jm-x £ ^ j.- f each one ounce. 

Compound Tincture of Gentian, ) 

Mix. Dose : One or two tablespoonfuls three times a day, before 

eating. To strengthen the system and increase the appetite. 



Wash or Gargle for Sore Throat or Mouth. 
Borax, one drachm, 
Tincture of Myrrh, half an ounce, 
Honey, one ounce, 
Hose Water, four ounces. 
Mix. To be used frequently as a mouth wash, or gargle for 
sore throat. 



Eye Water No. 1. 
Sulphate of Zinc, ) , . 
Sugar of Lead, [ each aXgramS - 
Rose Water or distilled water, four ounces. 
Mix. This mixture should be filtered before using, through 
paper, or not agitated when used. A few drops should be fre- 
quently applied to the eye, and if the inflammation be severe, a 
small linen cloth wet with it should be kept constantly applied. 
Adapted to acute inflammation of the eye. 



Valuable Receipts. 495 

Eye Water No. 2. — Wine of Opium, one ounce, Rose Water, ' 
one ounce, Sulphate of Zinc, two grains. Mix. To be applied 
several times a day. If it produce too much smarting add a little 
rain-water. 



Ointment for the Itch. — Hydriodate of Potash, half a drachm, 
Fresh Lard, one ounce, Oil of Bergamot, ten drops. Mix. To be 
applied to the affected parts every night. The clothes should 
be frequently changed, and the skin should be kept clean by the 
occasional use of soap and water. 

Ointment for the Piles. — Stramonium Ointment, two ounces, 
very finely Pulverized Nut-galls, two drachms, Pulverized Opium, 
eight grains. To be applied twice or thrice a day. 



Cooling Lotion. — Rose Water, four ounces, Lac Sulphur, two 
drachms, Sugar of Lead, one drachm. Mis. To be used as an 
external application in skin diseases, particularly itch, scald head 
and yellow spots. 



Soothing Liniment. — Soap Liniment, three ounces, Laudanum, 
two ounces, Oil Origanum, one ounce. Mix. An excellent liniment 
for rheumatism, neuralgia and other painful affections. The affect- 
ed part should be thoroughly bathed with it three or four times a 
day, and if the pain and soreness are not relieved a flannel cloth 
moistened with it should be kept constantly applied. In inflamma- 
tion of the bowels there is no better external remedy. 



Chloroform Liniment. — Chloroform, one and a half ounces, 
Sweet Oil, one and a half ounces, Spirits of Hartshorn, half an 
ounce, Laudanum, half an ounce. Mix. This is a very efficient 
external anodyne, and is adapted to the treatment of rheumatism, 
neuralgia, painful swellings and other diseases in which an anodyne 
embrocation is indicated. Great caution is necessary in using it that 
too much chloroform be not inhaled into the lungs. 



Lotion for the Itch. — Sulphuret of Potash, one ounce, Water, 
one pint, Sulphuric acid, half an ounce. Mix. The parts covered 
with the disease should be bathed with the lotion twice a day. At 
the same time great attention should be paid to cleanliness; the 
clothes should be changed often, and the skin kept perfectly clean 
by frequently bathing with soft water and a little soap or saleratus. 



496 Valuable Keceipts. 

Black Wash. — Lime "Water, four ounces, Calomel, one drachm. 
To be used as an external application to foul ulcers and chancres, 
and as an injection in gleet and obstinate cases of gonorrhoea. 



Beach's Neutralizing Cordial.—- Turkey Rhubarb, one ounce, 
Peppermint Leaves, half an ounce, Saleratus, one ounce. Mix part 
of the materials in a stone jar, and add one pint of boiling water; 
^let it stand till cold, then add half a pint of best brandy and half a 
pound of loaf sugar; digest for a day or two and strain through 
flannel; bottle for use. In some cases a little Tincture of Opium 
may be added to the powder before the water is poured on. Dose 
for an adult, a tablespoonful every thirty minutes, or according to 
the symptoms; for a child a year old, two teaspoonfuls every two 
hours. 

Use. — This is an invaluable remedy in cholera morbus, dysen- 
tery and diarrhoea. It is administered in every stage ot these 
diseases with the best effects. It is antacid and anti-dysenteric. 
This is a valuable remedy for the diseases in which it is recom- 
mended. The brandy is not absolutely essential in all cases, and 
in some would be injurious. The virtues of the preparation are 
improved, particularly in cases of vomiting, by the addition to the 
materials, of a heaped teaspoonful of powdered ginger. 



Wild Cherry Cordial. — Take Wild Cherry Bark, four ounces, 
Poplar Bark, four ounces. Make a strong tea by moderately steep- 
ing; strain off; add Loaf Sugar, four pounds, Kernels of Peach- 
stones, finely pulverized, four ounces, good Brandy or Whiskey, 
two quarts. Dose : half a wine-glass full several times a day. 

Use. — This is a most valuable astringent tonic, useful in all 
cases of obstinate diarrhoea and dysentery. It also combines the 
properties of a bitters, but the astringent by far predominates and 
is so powerful as to need using with care. " This cordial is a 
grateful and very valuable medicine." Howard. 



Tar Beer for Coughs, Colds &c. — Water, three quarts, Wheat 
Bran, one quart, Tar, one pint, Honey, half a pint. Simmer to- 
gether three hours, and when cool add a pint of brewer's yeast; 
let it stand thirty-six hours and then bottle it. Dose: from 
one to two tablespoonfuls three or four times a day. Useful in 
consumption and other lung affections attended with cough and 
copious raising. 



Valuable Receipts. 497 

Diuretic Mixture. — Acetate of Potash, one ounce, Antimonial 
"Wine, half an ounce, Pulverized Gum Arabic, one ounce, Cinnamon 
Water, one pint. Mix. Dose : a tablespoonful three or four times 
a day. Serviceable in dropsy and other diseases in which it is 
desirable to increase the secretion of urine. 



Tolu Cough Mixture. — Mucilage of Gum Arabic, one pint, 
Syrup of Tolu, two ounces, Wine of Ipecac, one ounce, Morphine, 
two grains. Mix. Dose for an adult, a tablespoonful and for 
children, from one to two teaspoonfuls three or four times a day. . 



Remedy for Whooping Cough. — Carbonate of Potash, half a 
drachm, Pulverized Cochineal, fifteen grains, Loaf Sugar, two 
drachms, Water, four ounces. Mix. Dose for children, a tea- 
spoonful every three or four hours. 



Diarrhoea Mixture. — Super Carb. Soda, three drachms, Aro>. 
matic Spirits of Ammonia, six drachms, Syrup of Ginger, three 
ounces, Com pound Tincture of Cardamom, three ounces, Cinnamon 
Water, ten ounces. Mix. Dose for children, one or two teaspoon- 
fuls every two or three hours. An excellent remedy for cholera 
infantum and all those complaints of children in which the dis- 
charges are ^reen, indicating acidity. One or two drops of lauda- 
num may be added occasionally if required, to check the discharge* 
or relieve pain. 



Pills for Headache, Neuralgia &c. — Extract of Hyoscyamus, 
half a drachm, Extract of Stramonium, four grains, Morphine, two 
grains, Quinine, two scruples, (40 grains,) Simple Syrup, sufficient 
to make a mass of suitable consistency to make into pills. Mix and 
divide into twenty pills. These pills are one of the best anodynes 
for nervous headaches, tic doloreux or neuralgic or spasmodic 
pains in any part of the system, we have ever used. One pill is a 
dose for a grown person, to be repeated every two or three hours 
till relief is obtained. 



Anti-Bilious Pills for Headache &c. — Pulverized Socotrine 
Aloes, half an ounce, Pulverized Gamboge, half an ounce, Ipecac 4 
half a drachm, Scammony, half a drachm, Castile Soap, three* 
drachms, Oil of Anise forty drops, Syrup of Buckthorn, sufficient 



498 Valuable Beceipts. 

to make "a mass.' Divide into four-grain pills, (common size.) 
Dose : from one to three. Useful in sick headache, jaundice, habit- 
ual costiveness, attacks of fever and in most cases where a catharic 
is indicated. A single pill at bed-time two or three times a week 
will often cure costiveness, dizziness and derangement of the 
stomach. 



Rheumatic Pills. — Pulverized Jalap, one drachm, Pulverized 
Colchicum Seeds, one drachm, Pulverized Gum Guaica, one 
drachm, Extract Conium, one drachm, Molasses, sufficient quantity. 
Mix and divide into one hundred and twenty pills. One pill may 
be taken at a time three or four times a day. If no relief is ob- 
tained, and their effect is not too great upon the bowels two may 
be taken at a time. Adapted to all cases of rheumatism, particu- 
larly the sub-acute and chronic forms, and to neuralgia, sciatica 
and Lumbago. 



Simple Purgative Pills. — Equal parts of Pulverized Jalap, 
Rhubarb, Aloes and Soda. Mix with the Tincture of Aloes and 
Myrrh (elix. prox.) and divide into common sized pills. Dose: 
from two to four. A single pill taken every night or two at bed- 
time is a good remedy for habitual costiveness. 



Pills for a Cough. — Pulverized Ipecac, Pulverized Squills, Ex- 
tract of Hyoscyamus, Extract of Conium, of each one drachm. Mix 
and divide into three-grain pills. Dose : one pill from four to six 
times in twenty-four hours. Useful in all ordinary coughs, and 
especially those of a consumptive character. 



Pills for Dyspepsia. — Sub. Nitrate (oxide) of Bismuth, half an 
ounce, Pulverized Cayenne Pepper, one drachm, Rhubarb, two 
drachms, Pulverized Ipecac and Aloes, each half a drachm. Mix 
with Mucilage of Gum Arabic and divide into one hundred and 
twenty pills. Dose : one pill to be taken at each meal-time, before 
eating. 



Tonic and Nervine Pill. — Valerinate of Zinc, one drachm, Ex- 
tract Conium, one drachm, Extract Gentian, two drachms. Mix. 
Divide into sixty pills, One pill to be taken three or four times a 
day. Applicable to the treatment of nervous affections attended 
with debility, palpitation of the heart and hysteria. 



Valuable Receipts. 499 

Tonic and Alternative Mixture. — Hydriodate of Potash, on© 
ounce, Fluid Extract of Coniuni, half an ounce, Fluid Extract of 
Sarsaparilla, twelve fluid ounces, Compound Tincture of Peruvian 
Bark, four fluid ounces. Mix. Dose: from one to two teaspoor fuls 
three times a day, before eating. In the treatment of scrofula and 
other chronic diseases this is a valuable compound. It is adapted 
to the cure of inveterate cutaneous eruptions, chronic rheumatism, 
disease of the liver, kidneys, some forms of dropsy and secondary 
syphilis, especially in those cases in which mercury has been tried 
without effecting a permanent cure. 



Iron Mixture. — Precipitated Carbonate of Iron, five drachms, 
Extract Conium, two drachms, Balsam Peru, one drachm, Alcohol, 
four ounces, Oil of Cinnamon, eight drops, Oil of Wintergreen, 
eight drops, Water, four ounces, Sugar, four ounces. Mix. This 
strengthening compound has proved to be one of the best remedies 
in general debility, menorrhagia, leucorrhoea, chlorosis, St. Vitus* 
dance and hysteria. The medium dose is two teaspoonfuls three 
times a day, in sugar and water. The vial should be well shaken 
before using. 



Antacid and Laxative Mixture. — Magnesia, two drachms, Pow- 
dered Rhubarb, half a drachm, Oil of Anise, twenty drops, Loaf 
Sugar, one drachm, Simple Cinnamon Water, one ounce, Pure 
Water, four ounces. Mix. One or two teaspoonfuls of this mix- 
ture is given with much advantage to children whose stomach and 
bowels abound in acidity, which occasions griping and colicky 
pains. On some occasions it may be useful to add a few drops 
of water of ammonia. 



Capital Cough Mixture. — Refined Extract Liquorice, half an 
ounce, Muriate of Ammonia, (Sal Ammonia) one drachm, Nitrate 
of Potash, one drachm, Ipecac, five grains. Mix. Dissolve in half 
a pint of boiling water. Dose : from half a tablespoonful taken 
four or five times a day. An excellent remedy for bronchitis, colds 
or catarrhal coughs. 



Pulmonic Mixture. — Paregoric Elixer, one ounce, Powdered 
Gum Arabic^ one ounce, Water, two ounces, Sweet Spirits of Nitre, 
two drachms, Antimonial Wine, one drachm. Mix. Dose: on© 
tablespoonful whenever the cough is troublesome. 



500 Medicated Inhalation. 

31EMCATED INHALATION.- For the cure uTCcmmmp- 
tion Asthma, Bronchitis, Sore Throat, Weakness or Loss of 
Voice, Catarrh in the Head, Weak Lungs, &c. 

F 

Simply swallowing medicine into the stomach has never 

been able to affect any good in removing disease from the 

nose, throat or lungs ; and hence the old practice of drugging, 

blistering, cupping, &c, has been productive of more harm 

han good. 

Among the new ideas that have dawned upon the great 
minds of the world is the one which questions the correct- 
ness of treating diseasess of the lungs and throat by medi- 
cating through the stomach and general circulation. To 
treat consumption and other diseases of the lungs through 
the stomach has been the practice for centuries, out it has 
always failed ! Thousands of remedies have been employed, 
but they were all addressed to the stomach, not the lungs. 
Is it not time to give attention to « new method for reaching 
the lungs with remedies ? 

To practice medicated inhalation successfully, its pharmacy 
must be thoroughly and scientifically comprehended. Medi- 
cines, when in a 6tate of vapor, ana inhaled into the lungs, 
affect the vital organization very differently from what they 
do when in their crude form or condition, and swallowed into 
the stomach. I will illustrate this by a single example: 
Half an ounce of chloroform may be swallowed into the stom- 
ach without producing fatal effects ; but that amount of chlo- 
roform inhaled in a state of vapor into the lungs would 
kill ten persons, unless properly diluted with atmospheric 
air. 

It is an easy matter to explain how medicine acts on the , 
system when inhaled in the form of vapor from a properly 
constructed inhaler. 

The medicines in this form are taken directly into the lung®, 
and being condensed when it reaches there, acts the same aa 
washing an ulcer or sore on the outer part of the body or ex- 
tremities, — thus healing up the sores or ulcers in the lungs, and 
allowing nature to recuperate. 

It has another advantage : When taken into the lungs in- 
■tead of the stomach it does not derange the digestive organs, 
liver, &c, but its healing and vitalizing properties are taken 
directly into the 6ystem, without the drawbacks which are wit- 
nessed in taking several different preparations into the stomach 
with a view to reaching the lungs. 

Persons who have flat chests, a feeble constitution, a slight 
hacking cough, catarrh in the head, a constant tickling in 



Medicated Inhalation. 501 

the throat, or a disposition to " hawk " or clear tlie throat, 
an inability to read or speak for any great length of time 
without becoming " hoarse," or tne voice " rough and husky ; " 
becoming tried oy any little extra exertion ; shortness of 
breath in ascending of stairs or walking up hill, a cough on 
first rising in the morning, spitting up of bloody matter, 
pains in the chest, and a hereditary predisposition to consump- 
tion (parent or parents having died with the disease), — all 
these symptoms should be taken as so many warning voices, 
appealing to the patient to beware of that dreadful malady 
that destroys millions yearly. 

Now, as the old 6ystem of drugging, blistering, &c, can 
never cure, neither ward off the disease (as medical men them- 
selves acknowledge), the only hope left for the patient being 
cured is " Medicated Inhalation" in connection with the other 
treatment I have referred to. 

Catarrh in the head, bronchitis, or long-continued trouble- 
some cough and sore throat, all may and often do lead to con- 
sumption, if neglected or not cured. All persons thus effected 
should apply at once for medical treatment. 

Let me be fairly understood. I do not pretend to say that 
consumption in every stage or in every case can be cured by 
the system of treatment lam advocating ; but I contend that 
as large a percentage of the cases (so called) can be cured of 
this as any other disease of a serious character ; and as none can 
be cured or any pretend to cure them by the old method, I 
claim that the system of " Medicated Inhalation," for diseases 
of the lungs, throat, &c., has a superior claim upon the public 
favor. 



INDEX. 



Page. 

Abscess, Common. 281 

-" Lumbar, 285 

" Mammary, 284 

Absorbent Medicines, 396 

Abstinence, 72 

Advice to the Young of Both 

Sexes, 471 

Advice to Young Men, 483 

After-Birth, Delivery of 198 

After-Pains, 201 

Age, Old 434 

Ague and Fever, 226 

Ague, Brow 248 

Air, Atmospheric 58 

" Night 60 

" Sea 61 

Albumen 75 

Albuminaria 470 

Anger, 93 

Angina Pectoris, 346 

Animal Fat, 77 

Ankle-Joint and Foot, 15 

Ankles, Weak 148 

Anodynes, 396 

Antacid and Laxative Mixture, 499 
Anti-Bilious Pills for Headache, 

etc, 497 

Antidotes for Poisons, 412 

Anti-Spasmodics, 400 

Anxiety of Mind, 94 

Apoplexy, 218 

Apple Tea, 162 

Appetite, 71 

Arm, Fracture of '. . . 295 

Artificial Nursing, 108 

Asthma, 266 

Astringents, 397 

Attendants on the Sick, 385 

Bacon, 78 

Baking, 83 

Bandages, 388 

" How to Apply 389 

Bandaging the Bowels, 181 

Barbers' Itch, 215 

Barley, 80 

Water, 162 

Barrenness, 225 

Bathing, 99 



Page. 
Beach's Neutralizing Cordial, . . 496 

Beds, 90 

Bed Rooms, 91 

BedClothes, 91 

Beef, 77 

" Tea, 162 

Bees, Stings of 290 

Bile, 437 

Bilious Colic, 366 

" Diseases, 438 

" Fever, 228 

" Headache, 248 

Biliousness, 438 

Bites of Venomous Snakes, .... 241 

" " Mad Dogs, 221 

Bitters, 398 

Bladder, Inflammation of 344 

" Stone in 318 

" Weakness of 437 

Black Wash, 496 

Bleeding from the Nose, 123 

Piles 288 

Blind Piles, 288 

Blisters, Dressing 387 

Blood, Spitting of 254 

" Vomiting of 262 

Bloody Flux, 375 

Urine, 381 

Boiled Eggs, 161 

Boil, 283 

" Gum 284 

Bones, Broken 291 

Boston Cracker Toast, 161 

Bowels, Bandaging of 181 

" Care of 95 

" Costiveness of 367 

" First Operations from.. 202 

" Inflammation of 339 

" Looseness of 131, 370 

Brain, Inflammation of 216 

" Water on the 158 

Bread, 81 

Breakfast, 84 

Breast, Gathered 284 

" Sore 206 

Bright's Disease of the Kidneys 470 

Broiling, 83 

Broken Bones, 291 



Index. 



503 



Page. 

Bronchitis, 148 

Broth, Mutton 162 

" Yeal 78 

Brow Ague, 248 

Bruises, 304 

Bunions, 215 

Burns, 268 

Butter, 76 

Buttermilk, 86 

Cabbage, 82 

Calves' Feet Jelly, 75, 161 

Cancer, 311 

Candies, 110 

Canker of the Mouth, 123 

Capital Cough Mixture, 499 

Carbonic Acid Gas, Inhaling. . . 235 

Carbuncle, 286 

Carminatives, 393 

Carrying Infants, 112 

Catarrh in the Head, 251 

Caustics, 402 

Cellars, 62 

Cessation of the Menses, 170 

Cheese . 76 

Change of Climate 429 

Chicken Pox, 155 

Chicken Soup, 78 

Chilblains, 431 

Children, Diseases of 120 

" Management of 98 

" Physical Education of 97 

Child, Duties Relative to 197 

" Dressing the 202 

" Washing the 201 

Chills and Fever, 226 

Choke Damp, 235 

Choking, 144, 317 

Cholera, 372 

" Infantum, 144 

" Morbus, 378 

Chloroform Liniment, 495 

Chronic Rheumatism, 274 

Clap, 441 

Clergyman's Sore Throat, 456 

Climate, 62 

" Change of 429 

Clothing 63, 99 

" Cotton 65 

" Linen 65 

" Woolen 65 

Cleanliness, 87 

Coffee, 86 

Cold in the Head, 334 

" Common 457 

Colds and Snuffles,. . . : 128 

Collar Bone, Dislocation of . . . . 304 



Page. 

Collar Bone, Fracture of 299 

Colic, 362 

" Bilious 366 

" Flatulent 364 

11 From Indigestion, 362 

" In Children, 132 

Compound Vegetable Tonic, . . . 494 

Conjugal Duties, 487 

" Irregularities, 278 

Consumption, 354 

Contusions, 304 

Convalescence, 462 

Convulsions, 133 

Cookery, 82 

Cooling Lotion, 495 

Corn Bread, 80 

Corns, 214 

Corsets, 66 

Costiveness in Adults, 367 

Children, 141 

Cough, Common 459 

" Hooping 140 

Counsels to a Young Woman. . 477 

Courses, 163 

" Deficient and Painful. 168 

" Retention of 185 

" Suppression of 167 

Courtship, 477 

Cramps, 178, 182, 238 

" From Drinking Cold 

Water, 240 

Cravat, 66 

Crying, 97 

Crabs, 79 

Croup, Crowing 127 

" Membranous 124 

" Spasmodic 127 

Cupping, 387 

Currant Water, 162 

Custard, 160 

Cuts, 306 

Damp, Choke 235 

Dance, St. Vitus' 229 

Deafness, 313 

Death, Apparent, from Inhaling 

Carbonic Acid Gas, 235 

Defects of Vision, 330 

Delirium Tremens, 217 

Delivery, Diseases After 203 

" of the After-Birth, .. . 198 

Demulcents, 401 

Derangements of Lochia, 208 

Diabetes, 379 

Diaphoretics, 394 

Diarrhoea, 131, 370 

" Mixture, 497 



504: 



Index. 



Page. 
Diet, (see Appetite and Cookery) 

" For Children, 102 

" " " (sick) 160 

Difficult Teething, 120 

Dinner, 84 

Diphtheria, 383 

Diseases of After-Delivery, .... 203 

" Children,....' 120 

" " Females, 163 

" the Ear, 142, 313 

" the Heart 347 

u a Pregnancy, 174 

" " the Skin, 281 

" the Eye,... 129, 327, 328 

Dislocations, 300 

" of the Collar Bone, 304 

" Elbow, 302 

" " Lower Jar,.. 303 

" Shoulder,... 302 

" Wrist, 302 

Diuretics, 393 

Diuretic Mixture, 497 

Dizziness of the Head, 247 

Doses of Medicines, 385, 406 

Dreaming, 92 

Dress, Head 65 

Dressing Blisters, 387 

Dressing the Child, 202 

Drinks, 85, 101 

Dropsy, 264 

Drowning, 233 

Duties Relative to the Child,. . . 197 

Dysentery, 145, 375 

Dyspepsia or Indigestion, ..158, 358 

" Bread, 160 

Ear, Diseases of 142, 313 

" Foreign Substances in . 142, 313 

Ears, Noises in 437 

Ear-ache, 142 

Education of Children, 97 

Eggs, 76 

" Boiled ,. 161 

Elbow, Dislocation of 302 

Emetics, 392 

Enlarged Veins, 326 

Ephemeral Fever, 207 

Epileptic Fits, 230 

Eruptions, Various 128 

Erysipelas, 421 

Examination of the Passage, ... 183 

Excesses in Marriage, 275 

Excoriations, 130 

Exercise, 68, 100, 112 

Expectorants, 395 

Exposure, 116 

External Parts, Soreness of 204 



Page. 

External Violence, 239 

Eye Appendages, 18 

" Ball, 16 

" Longitudinal Section of . . . 16 

" Muscles of 19 

" Posterior Segment of 18 

" Transverse Section of 17 

" Waters, 399 

" Water No. 1, 494 

" Water No. 2, 495 

Eyes, Diseases of 129, 327, 328 

Fainting, 204 

" Fits, 228 

Falling of the Fundament, 132 

" Womb, 172 

" out of the Hair, 464 

False Pains, 184 

Fat, Animal 77 

Fear, 93 

Feet, Care of 96 

Felon, 310 

Female Breast, 20 

Females, Diseases of 163 

Fever and Ague, 226 

" Bilious 228 

" Ephemeral 207 

" Milk 205 

" Puking 362 

'■ Scarlet 150 

" Typhoid 255 

" Typhus 255 

" Yellow 260 

First operations from the bowels 202 

First Stage of Labor, 185 

Fish, .- 78 

Fits, Apoplectic 218 

" Epileptic 232 

" Fainting 228 

Flatulence, 436 

Flatulent Colic, 364 

Flooding, 203 

Fluor Albus, 171 

Flux, Bloody 375 

Food, 73 

' ' Animal 74 

" Vegetable 73 

Foreign Bodies in the Ear, 142 

" Eyes,.... 327 
" " " Gullet,.. 317 

" " " Nose, ... 147 

Fore- Arm, Fracture of 295 

Fourth Stage of Labor, 196 

Fractures, 291 

Fracture of Arm, 295 

" " Collar Bone, 299 

•' " Fore- Arm, 295 



Index. 



505 



Page. 

Fracture of Knee Pan, 297 

" Leg, 298 

" Lower Jaw, 293 

" " Ribs, 294 

11 " Thigh, 296 

Friction, 71 

Frost-bitten Parts 457 

Frying, 83 

Fullness of Blood, 433 

Fundament, Falling of 132 

Gargles, 400 

Garters, 67 

Gathered Breast, 284 

Giddiness of the Head, 247 

Ginger Bread, 81 

Gleet, 449 

Gonorrhoea 441 

Gravel, 318 

Great Flow of Urine 379 

Grief, .' 93 

Growing in of Toe Nail, 331 

Gruel, Indian Meal 161 

" Oaten Meal 80, 161 

" Sweet Corn 161 

Gullet, Foreign Bodies in 317 

Gum Boil, 284 

Gums, Inflamed 121 

Hair, Care of 94 

" Falling out of 464 

Ham, 78 

Hanging, 235 

Hay- Asthma, 468 

" Fever, 468 

Head v Catarrh in the. 251 

" Cold in the 334 

" Dizziness in the 247 

" Dress, 65 

" Giddiness in the 247 

" Scald 136 

" Sore 135 

Headache, 248 

Bilious 248 

" Hysteric 248 

Nervous 248 

" Rheumatic 248 

Sick 248 

Health, How to Preserve 57 

Heart-Burn. 175, 359 

" Diseases, 347 

" Palpitation of 181, 350 

' ' and Lungs, 6 

Heat, Prickly 153 

Hemorrhage from the Lungs, . . 254 

" " Nose,.... 123 

" " " Stomach, 262 

'• Uterine 169 



Page. 

Hernia, 250 

" Strangulated 322 

Hiccup or Hiccough, 246 

Hooping Cough, 140 

Hope, 92 

Hornet, Sting of 290 

Hunger, 72 

Husband and Wife, Duties and 

Relations of. 487 

Hydrophobia, 221 

Hysteric Fits, 455 

" Headache, 248 

Hypochondria, 245 

Indian Bread, 80 

" Corn, 80 

Important Counsels, 471 

Impotence, 279 

Incontinence of Urine, 146 

Indigestion, 158, 358 

Indolent Ulcers, 325 

Infants, Nourishment of 102 

Infection, Propagation of Dis- 
ease by 459 

Inflammation of the Bladder, . . 344 

" Bowels,... 339 

" Brain,.... 216 

" Kidneys,.. 343 

" " Larynx, . . 333 

Inflammation of the Liver, 

(acute) 341 

Inflammation of the Liver, 

(chronic) 342 

Inflammation of the Lungs, 149, 336 
" Stomach, 

(acute) 338 

Inflammation of the Stomach, 

(chronic) 339 

Inflammation of the Tonsils, . . . 331 
" Top of 

Wind Pipe, 333 

Inflammatory Rheumatism, .... 271 

Influenza, 428 

Injections, 386 

" Purgative 393 

Insects, Venomous, Bites of. ... 241 

' ' Poisonous Stings of . ... 290 

Intemperance, 486 

Intermittent Fever 226 

Intestine, Small 23 

Irritable Ulcers, 324 

Iron Mixture, 499 

Isinglass Jelly, 160 

Itch, 155 

" Barbers' 215 

" Lotion for 495 

Itching of the Outer Parts, 177 



506 



Index. 



Page. 

Jaundice, 360 

Jaw, Lower, Dislocation of . . . . 303 

" " Fracture of 293 

Jealousy, 489 

Jelly, Biscuit 160 

Calves Feet 75, 161 

Isinglass 160 

Moss 161 

Orange 160 

Eice 160 

Sago 160 

Tapioca 160 

Joints, Wounds of 309 

Joy, 92 

Kidney, Section of 15 

Kidneys, Bright's Disease of . . . 470 

" Inflammation of 343 

King's Evil, 465 

Knee Pan, Fracture of 297 

Labor, 182 

First Stage of 185 

Second Stage of 190 

Third Stage of 192 

Fourth Stage of 196 

Natural 182 

Signs of 184 

Lacing, Tight 66 

Lamb, 77 

Larynx, Inflammation of 333 

Leg, Fracture of 298 

" Swelled 209 

Lemonade, 160 

Lightning, Stroke of 237 

Liver, Diseases of 341 

' ' Inflammation of (acute). . 341 
" " " (chronic) .342 

List of Medicines, 385 

Lobsters, 79 

Local Irritating Remedies, 401 

Lochia, Its Derangements, 208 

Lock Jaw, 224 



.131. 



370 
330 
495 
93 
483 
303 
293 



Looseness of the Bowels 

Long-sightedness, 

Lotion for the Itch, 

Love, 

Lovers, Important Counsel to 
Lower Jaw, Dislocation of . . . 

" " Fracture of 

Lower Limbs, Swelling of 181 

Lowness of Spirits, 245 

Lumbar Abscess, 285 

Lungs, Inflammation of 149, 336 

Mad Dog, 221 

Maidens, Advice to 471 

Maidenhood, Dangers of 472 



Maize, 



80 



Page. 

Malignant Sore Throat, 143 

Mammary Abscess, 284 

Glands, 20 

Marital Errors, . . .- 488 

Marriage Excesses, 276 

Marshes, 60 

Masturbation, 452 

Meals, 83 

Meats, Broiled 161 

" Unhealthy, Sickness from 287 

" Salted 79 

Measles,. 136 

Medicated Inhalations, 500 

Medicines, Classification of . . . . 391 

" Doses of 406 

" For Acidity in the 

Stomach, 396 

Medicines for Medicine Chest,.. 405 

" Spasms, 400 

" " Worms, 399 

" Proper Time to Give 385 

Their Doses & Uses, 385 

" To Allay Pain 396 

" Check Looseness 397 
" Check Vomiting 398 
" " Bring Phlegm 

from the Lungs, 395 

Medicines to Expel Wind, 393 

" " Lessen Discharges, 397 
" " Strengthen the 

System, 398 

Medicines to Produce Perspira- 
tion, 394 

Medicines to Promote Flow of 

Urine, 393 

Meibomian Glands, 18 

Menstruation, . 163 

" Profuse 169 

Menses, 163 

" Cessation of 170 

" Deficient 168 

" Painful 168 

1 ' Eetention of 165 

" Suppression of 167 

Mesenteric Circulation, 23 

Milk, 75 

" Ducts, 20 

" Fever, 205 

" Leg, 209 

" Porridge, 162 

" Sago, 161 

" Sickness, 362 

" Toast, 161 

Midwifery, 182 

Mind, Anxiety of 94 

Miscarriage, 178 



Index. 



50' 



Page. 

Miscellaneous Receipts, 402 

Monthly Turns, 163 

Morbid Passions of 473 

Morning Sickness, 175 

Mortification, 315 

Moss Jeliv 161 

Mouth, Can leer of 123 

Movement (Jure, 411 

Mucilage, S igo 162 

Mumps, 345 

Mussel, 79 

Mutton, 77 

" B oth, 162 

Neck, Wry 326 

Nerves of the Face and Head, . . 22 

Nervousness, . 431 

Nervous Debility, 275 

Neuralgia 242 

Nervous Headache, 248 

Nettle Rash, 157 

Newly Married, a Chapter for.. 487 

Night Air, 60 

Nightmare, 92 

Nipples, The. 181 

" Sore 205 

Noises in the Ears, 437 

Nose, Foreign Bodies in 147 

11 Septum of Nerves, 19 

Nourishment of Infants, 102 

Nurses, Qualifications of 385 

Nursing, Artificial 108 

Oaten Gruel, 161 

" Meal, 80 

Ointments, 401 

Ointment for the Itch, 495 

" Piles, 495 

Old Age, 434 

Orange Jelly, 160 

Out of Joint, 300 

Outer Parts, Itching of 177 

Ovaries, Anatomy of 27 

Oysters, 79 

Oyster Scrip, 162 

Pain in the Breast, 346 

" & I acuity in Urinating, 177 

Pains, F.. e 184 

Palpitatu i of the Heart,... 181, 350 
Palsy, 219 

11 Lead 220 

" Sha ing 220 

Panado, 81, 160 

Paralysis, 219 

Parental J aties, 481 

Parotide md, 23 

Passage, I camination of 183 

Passions, The 92 



Page. 

Pastry, .. 81 

Phthisic, 266 

Physiology and Philosophy of 

Right Living, 471 

Piles, 176, 288 

" Bleeding 288 

" Blind 288 

Pills for a Cough, 498 

" " Dyspepsia, 498 

" " Headache, Neuralgia, 

etc., 497 

Pimples in the Face, 210 

Plasters, 403 

Plethora, 433 

Pleurisy, 338 

Pneumonia, 336 

Poisons and Their Antidotes, . . 412 

Poison-Vine Eruption, 470 

Pork 78 

Porridge, Milk 162 

Potatoes, 82 

" Roasted 161 

Poultices, 388 

Poultry, 78 

Pox, 446 

Pregnancy, Its Signs and Dis- 
eases, 173 

Preservation of the Sight, 95 

Prickly Heat, 153 

Profuse Menstruation, 169 

Propagation of Diseases, 459 

Proper Time for Sleep, 89 

Puberty, 474 

Puddings, 81 

Rice 161 

Starch 160 

Puking Fever, 362 

Pulmonic Mixture, 499 

Purgatives, 391 

Purging and Vomiting, 378 

Putting to Bed, 200 

Qualifications of Attendants on 

the Sick, 385 

Quantity of Sleep, 89 

Rash, Nettle 157 

Recipes, Miscellaneous 402 

Remedy for Whooping Cough, . 497 

Remittent Fever, 228 

Retention of the Menses, 165 

Retention of the Urine, 381 

Rheumatic Pills, 498 

Rheumatism, 271 

Chronic 274 

" Inflammatory 271 

Ribs, Fracture of 294 

Rickets, 147 



508 



Index. 



Page. 

Rice, 80 

" Caudle, 160 

" Jelly, 160 

" Pudding, 161 

Riding, 70 

" Carriage 114 

Ring Worm or Tetter, 154 

River Sickness, 362 

Roasting, 83 

Rowing, 70 

Rupture, 250 

" Strangulated 322 

Rye, 80 

Sago, 82 

" Jelly, 160 

" Milk, 161 

" Mucilage, 162 

Salted Meats, 79 

Salivation, 427 

Sausages, 78 

Scald Head, 136 

Scalds, 268 

Scarlet Fever, 150 

Sciatica, 440 

Scrofula, 465 

Scurvy, 352 

Second. Stage of Labor, 190 

Secret Habits, 276 

" of Youth, 452 

Sea Air, 61 

Sea Sickness, 243 

Shaking Palsy, 220 

Shingles, 210 

Short Sightedness, 330 

Shoulder, Dislocation of 302 

Sick Children, Diet for 160 

Sick Headache, 248 

Sickness, from unhealthy meats 287 

Milk 362 

" Morning 175 

" River 362 

" Swamp . 362 

Sight, Preservation of 95 

" Short and Long 330 

" Weak 330 

Signs of Labor, 184 

<k Pregnancy, 173 

Simple Purgative Pills, 498 

Skin, Eruptions of 128 

" Diseases of 281 

1 ' Pores and Papillae of 21 

" Section of 21 

" Structure of 21 

Sleep, 89, 100 

" Proper Time for 89 

" Quantity of 89 



Page. 

Sleep, To Promote 89 

Slows, 362 

Small-Pox, 211 

Snake Bite, 241 

Snuffles and Colds, 128 

Soap, 88 

Soothing Liniment, 495 

Sore Breast, 206 

" Eyes, 129, 328 

" Head, 135 

" Nipples,.. 205 

" Throat, 331 

' ' Clergyman's 456 

" Malignant 143 

Sores, 323 

" Running., 323 

Soup, 79 

" Beef 79 

" Chicken 78 

" Mutton 79 

" Oyster 162 

" Veal 78 

Sour Crout, 82 

Sourness of the Stomach, 359 

Spasms or Convulsions, 133 

Spirits, Lowness of 245 

Spitting of Blood, 254 

Sprains, 305 

St. Vitus' Dance, 229 

Stammering, 149 

Starch Pudding, 160 

Sterility, 225 

Stewing, 83 

Stiff Joints, 362 

Stimulants, 400 

Sting of Bees, Wasps, etc., .... 290 
Stomach (See Appetite and 

Cooking) 

Stomach, Cramps in the. ...182, 240 

' ' Inflammation of 338 

" Sourness of the 359 

Wind in the 130 

Stone in the Bladder, 321 

Strangury, 177, 383 

Strangulated Hernia, 322 

Strictures, 469 

Stroke of Lightning, 237 

Stye, 328 

Summer Bronchitis, 468 

Sun Stroke, 220 

Supper, 85 

Suppression of Mei_ses, 167 

"Urine, 382 

Swamp Sickness, 362 

Sweat Gland, 21 

Sweet Meats, 110 



Index. 



509 



Page. 
Swelling of the Lower Limbs. . 181 

Swelled Leg, • 209 

Swimming,. 70 

" In the Head, 247 

Symptoms of Diseases, 426 | 

Syphilis, 446 ' 

Table of Medicines, 406 

Tamarind Water, 162 

Tapioca Jelly, 160 

Tar Beer for Coughs, Colds, etc 496 

Tea, 86 

" Apple 162 

" Beef 162 

Teething, Difficult 120 

Telling Diseases by the Tongue, 425 

Tetanus, 224 

Tetter or Ring Worm, 154 

Thigh, Fracture of 296 

Third Stage of Labor, 192 

Throat, Foreign Bodies in .... . 317 

Throat, Sore 143, 331 

Thrush, 122 

Tight Lacing, 66 

Tires, 362 

Toast, Boston Cracker 161 

" Milk 161 

" Water 85 

Toe Nail, Growing in of 331 

Tongue, The 97 

" Telling Diseases by . . . 425 

Tolu Cough Mixture, 497 

Tonics, 398 

Tonic and Alternative Mixture. 499 

Tonic and Nervine Pill, 498 

Tonsils, Inflammation of 331 

Toothache, 121 

Trusses, 250 

Turns, Monthly 163 

Typhoid Fever, 255 

Typhus Fever, 255 

Ulcers, 323 

" Indolent 325 

" Irritable 324 

" In Weakened Parts, 324 

" Running 323 

Unhealthy Meats, Sickness from 287 

Urinary Bladder, . 15 

Urinate, Frequent Desire to. . . . 383 

Urinating, Painful 177 

Urine, Bloody 381 

" Great Flow of 379 

" Incontinence of 146 

" Retention of 381 



Page. 

Urine, Suppression of 382 

Uterine or Womb Diseases, .... 171 

Vaccination, 156 

Valuable Receipts, 494 

Varicocele, 244 

Varicose Veins, 326 

Various Diseases, 210 

Veal, 78 

" Broth, 78 

Veins, Enlarged 326 

" Varicose ....... 326 

Venison, 78 

Venomous Insects, Bites of . . . . 241 
Vermifuge to Destroy Worms. . 494 

Vision, Defects of 330 

Ventilation, 62 

Vomiting of Blood, 262 

Vomiting and Purging, 378 

Walking, 69, 115 

Warts, 213 

Wash or Gargle for Sore Throat 

or Mouth, 494 

Wasp, Sting of 290 

Water, Brash 360 

" Currant 162 

" on the Brain, 158 

" Tamarind 162 

Weak Ankles, 148 

" Sight, 330 

Weakness of the Bladder, 437 

Weaning, 117 

Weed, 207 

Wens 325 

Whey, 85 

Whites, 171 

Whitlow, 310 

Wild Cherry Cordial, 496 

Wind in the Stomach, 130 

Windpipe, Inflammation of . . . . 333 

Wine Whey 162 

Womb, Anatomy of 27 

" Diseases of 171 

" Falling of 172 

Worms, 139 

" in the Face, 210 

Worm Medicines, 399 

Wounds, 306 

" of the Joints. 309 

Wrist, Dislocation of 302 

Wry Neck, 326 

Yellow Fever, 260 

Youthful Indiscretions, 482 



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You have common sense and common school education ! now educate your- 
self by this book, about yourself , and how to give, act, do and not do, in the 
little things and simp te ailments of the human fame, and you will be glad that 
you ever bought this book. 

The book is bound in Extra Cloth, Gilt back and Embossed sides, and is 
sold at the extremely low price of 

*-*-*ee^$2.50 PER COPY,s^ 

And will be delivered free of expense in any part of the civilized world ! 
Address all communications to the Publishers, 

COAST CITY PUBLISHING COMPANY, 
Office, 49 NASSAU ST., (P. 0. Box 667.) NEW Y0E& 

Good Agents Wanted in all parts of the World, to sell this book. The 
jargest commission allowed ever given on a scientific work. Address as above, 
or call in person, for terms, &c. 







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